Influence of lipoprotein-associated phospholipase A2 mass on prognosis value of baseline platelet count for clinical outcomes after acute ischemic stroke.

Abstract

BACKGROUND AND AIMS:

We aimed to examine the association between baseline platelet count (PLT) and prognosis of acute ischemic stroke according to lipoprotein-associated phospholipase A2 (Lp-PLA2) mass.

METHODS:

A total of 3254 patients with acute ischemic stroke were included in this analysis. The primary outcome was a combination of major disability and all-cause mortality (modified Rankin Scale score ≥3) at 3 months after stroke. Secondary outcome was major disability and all-cause mortality, respectively.

RESULTS:

The prognosis value of PLT for primary outcome was significantly modified by Lp-PLA2 mass (pinteraction = 0.002). After multivariate adjustment, elevated PLT was associated with the increased risk of primary outcome in patients with high Lp-PLA2 mass (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.09-2.48; ptrend = 0.002), but not in those with low Lp-PLA2 mass (OR, 0.94; 95%CI, 0.62-1.42; ptrend = 0.181), when comparing two extreme PLT quartiles. A similar association was found between elevated PLT and major disability (pinteraction = 0.001). Elevated PLT was associated with increased risk of major disability only in patients with high Lp-PLA2 mass (OR, 1.54; 95%CI, 1.03-2.31; ptrend = 0.007), for the highest quartile vs the lowest quartile. Each 100 × 109/L increment in PLT was associated with 42% (95%CI, 12%-79%) increased risk of primary outcome and 33% (95%CI, 6%-68%) increased risk of major disability in those with high Lp-PLA2 mass.

CONCLUSIONS:

The elevated PLT was associated with poor prognosis of acute ischemic stroke only in patients with high Lp-PLA2 mass. Lp-PLA2 might be an important factor influencing the prognosis value of PLT for clinical outcomes in acute ischemic stroke patients.

• Authors: Suwen Shen, Chongke Zhong, Aili Wang, Liyuan Han, Zhengbao Zhu, Yanbo Peng, Hao Peng, Daoxia Guo, Xiaowei Zheng, Tan Xu, Jing Chen, Zhong Ju, Deqin Geng, Yonghong Zhang, Jiang He
• Journal: Atherosclerosis (Atherosclerosis) Vol. 306 Pg. 50-56 (08 2020) ISSN: 1879-1484 [Electronic] Ireland
• PMID: 32688104 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2020 Elsevier B.V. All rights reserved.

Chemical References

• Biomarkers
• 1-Alkyl-2-acetylglycerophosphocholine Esterase

Topics

• 1-Alkyl-2-acetylglycerophosphocholine Esterase (pharmacology)
• Biomarkers
• Brain Ischemia (diagnosis)
• Humans
• Ischemic Stroke (drug therapy)
• Platelet Count
• Prognosis
• Risk Factors
• Stroke (diagnosis)