Mean platelet volume and mechanical thrombectomy

J Stroke Cerebrovasc Dis. 2020 Aug;29(8):104971. doi: 10.1016/j.jstrokecerebrovasdis.2020.104971. Epub 2020 Jun 9.

Abstract

Background and purpose: Mean Platelet Volume (MPV) is a marker of platelet activity and it is an independent predictor for long-term outcome in stroke patients. The aim of this study was to evaluate the association between baseline MPV value and clinical outcome at 90-days in anterior circulation stroke and large vessel occlusion (LVO) patients submitted to mechanical thrombectomy (MT).

Methods: We conducted a prospective observational cohort study in acute ischemic stroke (AIS) patients submitted to MT between January 2017 and May 2018. MPV was measured at admission. Patients were initially stratified into two groups according to the mean MPV level. We also compared groups that were stratified according to the MPV cut-off obtained by Peng F et al (10,4 fL) and performed analyses among MPV terciles.

Results: A total of 129 patients were included. Mean level of MPV was 10,9 fL. Patients with embolic stroke of undetermined source (ESUS) had significantly higher rates of good outcome at 3 months compared with large-artery atherosclerotic disease and cardioembolism [(82,9%) vs (78,3%) vs (55,2%); p=0,009]. There were no statistically significant differences in the mean MPV value (p=0,222), successful recanalization (p=0,464) and mortality (p=0,343) when evaluated for all TOAST etiologies. There were no statistically significant differences between the two groups according to the MPV level (10,4 and 10,9 fL) or between the terciles (lowest tertile <10,3 fL, median 10,3 - 11,3 fL, highest >11,3fL) concerning functional outcome at 3 months (p=0,357; p=0,24 and p=0,558, respectively), successful recanalization (p=0,108; p=0,582 and p=0,899, respectively) or mortality at 3 months (p=0,465; p=0,061 and p=0,484, respectively).

Conclusion: Our study did not find an association between elevated MPV and worse outcome at 3 months in patients with acute anterior circulation stroke and LVO treated with MT. Since ischemic strokes have different pathophysiologic mechanisms, MPV may have distinct prognostic value according to each stroke etiology.

Keywords: Acute ischemic stroke; Functional outcome; Mean Platelet Volume; Mechanical Thrombectomy; Stroke Subtypes.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Brain Ischemia / blood
  • Brain Ischemia / diagnosis
  • Brain Ischemia / mortality
  • Brain Ischemia / therapy*
  • Databases, Factual
  • Disability Evaluation
  • Female
  • Humans
  • Male
  • Mean Platelet Volume*
  • Middle Aged
  • Predictive Value of Tests
  • Prospective Studies
  • Recovery of Function
  • Risk Factors
  • Stroke / blood
  • Stroke / diagnosis
  • Stroke / mortality
  • Stroke / therapy*
  • Thrombectomy* / adverse effects
  • Thrombectomy* / mortality
  • Time Factors
  • Treatment Outcome