Published Online
on May 13, 2004

A more recent version of this article appeared on July 1, 2004

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Submitted on December 23, 2003
Revised on March 12, 2004
Accepted on March 21, 2004

Is Elevated Mean Platelet Volume Associated With a Worse Outcome in Patients With Acute Ischemic Cerebrovascular Events?

S. Greisenegger MD; G. Endler MD; K. Hsieh MD; S. Tentschert MD; C. Mannhalter PhD; and W. Lalouschek MD, PhD^*

From the Clinical Department of Clinical Neurology (S.G., K.H., S.T., W.L.) and Institute of Medical and Chemical Laboratory Diagnostics, Division of Molecular Diagnostics (G.E., C.M.), Medical University of Vienna, Vienna, Austria.

^* To whom correspondence should be addressed. E-mail: wolfgang.lalouschek{at}univie.ac.at.

Background and Purpose--Increased mean platelet volume (MPV), indicating higher platelet reactivity, is associated with an increased risk of myocardial infarction. Higher levels of MPV have been found in patients with acute ischemic stroke than in control subjects. Data from smaller studies regarding an association between MPV and stroke severity and outcome have been controversial. If such an association exists, MPV might help to identify patients at increased risk of a severe course of acute cerebrovascular disease.

Methods--Within a multicenter, cross-sectional study nested in a cohort, we analyzed the relation between MPV and stroke severity as determined by the modified Rankin Scale after 1 week in 776 patients with acute ischemic stroke or transient ischemic attack. By multivariate logistic regression modeling, we determined the influence of MPV on stroke severity, adjusting for potential confounding factors.

Results--Patients within the highest quintile of MPV had a significantly higher risk of suffering a severe stroke, defined as modified Rankin Scale score of 3 to 6, compared with patients within the lowest quintile (odds ratio=2.6; 95% confidence interval, 1.6 to 4.1; P<0.001). This association remained significant after adjustment for possible confounding factors (odds ratio=2.2; 95% confidence interval, 1.2 to 4.0; P=0.013).

Conclusions--Our results indicate that an elevated MPV is associated with a worse outcome for acute ischemic cerebrovascular events independent of other clinical parameters.

Key words: stroke • platelets • stroke outcome

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