Lower coated-platelet levels are associated with early hemorrhagic transformation in patients with non-lacunar brain infarction

J Thromb Haemost. 2010 Jun;8(6):1185-90. doi: 10.1111/j.1538-7836.2010.03851.x. Epub 2010 Mar 9.


Background: Coated-platelets, representing a subset of platelets with procoagulant potential, are elevated in patients with non-lacunar ischemic stroke and decreased in patients with spontaneous intracerebral hemorrhage. However, within the non-lacunar patient population there are individuals with lower levels of coated-platelets, which raises the possibility that these individuals would be susceptible to early hemorrhagic transformation (HT) of ischemic stroke.

Objective: Because extremes in coated-platelet potential may be associated with either thrombotic or hemorrhagic events, we undertook a pilot study to investigate whether there is an association between coated-platelet production and the presence of early HT in patients with non-lacunar ischemic stroke.

Patients and methods: Coated-platelet levels were determined in 115 consecutive eligible patients with a diagnosis of non-lacunar ischemic stroke. Early HT was determined on CT scan examination and confirmed by MRI studies. The distribution of coated-platelet levels was summarized using the median and interquartile range (25th-75th percentiles) and compared statistically between patients with and without early HT using the non-parametric Wilcoxon rank sum test.

Results: The median coated-platelet level in all non-lacunar stroke patients was 38.0% (interquartile range 30.5-48.3%). Early HT was detected in 11 patients (9.6%), and these patients had significantly lower coated-platelet levels compared with those without early HT [median 25.1% (interquartile range 20.4-35.5%) vs. 39.2% (31.6-49.5%), P = 0.003].

Conclusions: Lower levels of coated-platelets are associated with the presence of early HT in patients with non-lacunar ischemic stroke.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Platelets*
  • Cerebral Hemorrhage / diagnostic imaging
  • Cerebral Hemorrhage / pathology*
  • Cerebral Infarction / diagnostic imaging
  • Cerebral Infarction / physiopathology*
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Tomography, X-Ray Computed