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  • 1
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    Online Resource
    Abstract TP522: Clopidogrel Use and Smoking Cessation Result in Lower Coated-Platelet Levels After Stroke
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Stroke Vol. 50, No. Suppl_1 ( 2019-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 50, No. Suppl_1 ( 2019-02)
    Abstract: Introduction: Coated-platelets are a subset of highly procoagulant platelets observed upon dual-agonist stimulation with collagen and thrombin. Coated-platelet levels are elevated in patients with ischemic stroke and associated with stroke recurrence. Cross-sectional studies in controls showed that smoking was associated with higher coated-platelet levels whereas chronic use of serotonin reuptake inhibitors (SSRIs), statins or aspirin was associated with lower coated-platelet levels. Limited data in patients with coronary artery disease have shown an inhibitory effect on coated-platelet potential at 24 hours following the administration of a 300 mg single dose of clopidogrel. We now investigate if initiation of pertinent medications and smoking cessation result in long-term changes in coated-platelet levels following ischemic stroke. Methods: Coated-platelet levels, reported as percent of cells converted to coated-platelets, were measured in 87 consecutive patients with non-lacunar stroke at baseline and repeated at 90 days. Repeated-measure ANOVA was used to determine if initiation of treatment with SSRIs, statins, clopidogrel, aspirin, oral anticoagulants or smoking cessation impacted changes in coated-platelet levels. Results: Initiation of treatment with clopidogrel (absolute decrease = 8.9%, relative decrease = 20.9%, p = 0.0001, partial η 2 = 0.17) and smoking cessation (absolute decrease = 8%, relative decrease = 18.2%, p = 0.014, partial η 2 = 0.10) resulted in decreased coated-platelets levels at 90 days as compared to baseline. Use of SSRIs, statins, aspirin or oral anticoagulants did not result in significant changes. Conclusions: Clopidogrel use and smoking cessation attenuate coated-platelet potential at 90 days after ischemic stroke. These data suggest that both pharmacological agents and behavioral modification result in long-term modulation of coated-platelet production likely through inhibition of the P2Y12 receptor and inflammatory pathways. Future studies are needed to better define mechanisms involved.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.50.suppl_1.TP522
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
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  • 2
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    Abstract TP571: Coated-Platelets, RANTES and IL-7 Correlate With Silent Brain Infarction in Carotid Stenosis
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Stroke Vol. 50, No. Suppl_1 ( 2019-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 50, No. Suppl_1 ( 2019-02)
    Abstract: Background: Silent brain infarction (SBI) is associated with both cognitive decline and recurrent stroke. While cortical SBI may have an embolic source, the etiology of subcortical SBI (80% of SBI) is less clear. We now examine the association between coated-platelets (procoagulant platelets observed upon dual agonist stimulation with collagen and thrombin), soluble mediators of inflammation, cell adhesion, angiogenesis and coagulation and SBI in carotid stenosis patients. Methods: Asymptomatic patients with ≥50% carotid stenosis were enrolled, coated-platelets assayed, and plasma obtained for measurement of 58 plasma biomarkers. Presence and location of SBI, defined as a focal, ≥ 3mm cavitary lesion with T1 hypointensity and T2 hyperintensity features on MRI within 12 months of enrollment, were recorded. Variables correlating (p 〈 0.10) with SBI were included for multiple regression and retained if p 〈 0.05. Results: Thirty-two subjects were analyzed. Cardiac ejection fraction (r= -0.34, p=0.0325), coated-platelets (r=0.5471, p=0.0014) and IL-7 (r=0.35, p=0.0498) correlated with overall SBI number. Antiplatelet use (r= -0.63, p=0.0001), coated-platelets (r=0.43, p=0.0152) and RANTES (r=0.39, p=0.0283) correlated with cortical SBI number. Beta blocker use (r= -0.40, p=0.0238) and coated-platelets (r=0.52, p=0.0030) correlated with subcortical SBI number, with a trend for correlation between IL-7 and subcortical SBI number (r=0.35, p=0.0518). Multivariate analysis revealed coated-platelet levels ≥40.5% and lack of beta blocker use were associated with subcortical SBI (OR=35.22, p=0.0057 and OR=10.74, p=0.0347 respectively). Discussion: Our results demonstrate a strong association between coated-platelets and SBI regardless of anatomic location. We have also identified two inflammatory mediators associated with cortical (RANTES) and subcortical (IL-7) SBI location. Our findings suggest protective effects of antiplatelet use for cortical SBI and beta blocker use for subcortical SBI. Altogether, these data support a thrombotic mechanism of SBI with differing auxiliary mechanisms for cortical and subcortical SBI that may involve alternate inflammatory pathways.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.50.suppl_1.TP571
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
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  • 3
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    Abstract W P374: Coated-Platelet Levels Correlate With HAS-BLED Scores in Stroke Patients With Atrial Fibrillation
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Stroke Vol. 45, No. suppl_1 ( 2014-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 45, No. suppl_1 ( 2014-02)
    Abstract: Background: Coated-platelets are a subset of procoagulant platelets observed upon dual agonist stimulation with collagen and thrombin. Coated-platelet levels are increased in non-lacunar ischemic stroke compared to controls; however, patients with early hemorrhagic transformation have lower coated-platelet levels than those without. In contrast to brain infarction, coated-platelet levels are decreased in intracerebral hemorrhage and inversely correlated with the size of the bleed. Because anticoagulation is a key preventive treatment in cardioembolic stroke, we investigated the existence of a relationship between coated-platelets and bleeding risk in stroke patients with atrial fibrillation. Methods: Coated-platelet levels, reported as percent of platelets converted to coated-platelets, were determined in 45 consecutive patients with acute stroke and atrial fibrillation. Exclusion criteria consisted of dementia, stroke due to other causes than atrial fibrillation, 〉 96 hours between onset of symptoms and coated-platelet assay, current anticoagulation, prior thrombolytics or abnormal PT/PTT/INR. Bleeding risk was determined for each patient using the HAS-BLED score. The correlation between individual coated-platelet levels and HAS-BLED scores was determined using the Pearson correlation coefficient. Results: Coated-platelet levels for the 45 patients were 41.0 ± 13.9% (mean ± SD, range 13.2 to 69.7%), consistent with previous data in patients with non-lacunar ischemic stroke. Mean HAS-BLED score was 3.2 ± 1.6, with a range between 1 and 7. A highly significant inverse linear correlation between coated-platelet levels and HAS-BLED scores was observed (p 〈 0.001, r = -0.67). Conclusions: Lower coated-platelet levels correlate with higher HAS-BLED scores in patients with stroke due to atrial fibrillation, suggesting that decreased coated-platelet synthesis is present in patients with an increased risk for bleeding. Our results are consistent with previously published research showing lower coated-platelet levels in intracerebral hemorrhage and early hemorrhagic transformation of ischemic stroke, and support a role played by this subset of activated platelets in the balance between thrombosis and hemorrhage.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.45.suppl_1.wp374
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
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  • 4
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    Abstract WP146: Degree of Carotid Stenosis is Associated with Coated-platelet Levels
    Ovid Technologies (Wolters Kluwer Health) ; 2013
    In:  Stroke Vol. 44, No. suppl_1 ( 2013-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 44, No. suppl_1 ( 2013-02)
    Abstract: Background: Coated-platelets, a subset of procoagulant platelets observed upon dual agonist stimulation with collagen and thrombin, support a robust prothrombinase activity and provide a unique measure of platelet thrombotic potential. Coated-platelet levels are elevated in patients with non-lacunar ischemic stroke and decreased in patients with spontaneous intracerebral hemorrhage compared to controls. Because these findings suggest that extremes in coated-platelet levels may be associated with either thrombotic or hemorrhagic events, we investigated coated-platelet synthesis in symptomatic and asymptomatic patients with carotid artery stenosis. Methods: Coated-platelet levels were determined in 3 consecutively recruited groups: 1) patients with acute transient ischemic attack or stroke and ≥50% ipsilateral internal carotid artery stenosis (n=45); 2) asymptomatic patients with ≥50% carotid stenosis (n=68), and 3) asymptomatic patients with 〈 50% carotid stenosis (n=92). Results are reported as percent of cells converted to coated-platelets. Differences between groups were assessed using independent t-tests and Fisher’s exact tests. The relationship between group and coated-platelet levels was assessed with a three-way ANOVA and Tukey’s HSD test. Results: Coated-platelet levels (mean±SD) differed among the groups (F = 5.12, p = 0.007) with significant elevations among symptomatic carotid stenosis patients (39.5±16.3, p = 0.003) and asymptomatic ≥50% carotid stenosis patients (37.1±12.6, p = 0.028) compared to 〈 50% carotid stenosis patients (32.5 ± 11.5).These differences remained significant after adjusting for age and medication use (F=5.07, p 〈 0.0001). No significant difference was noted between symptomatic and asymptomatic carotid stenosis patients with ≥50% stenosis (p = 0.33). Conclusions: These results suggest that the presence of ≥50% carotid stenosis is associated with an increase in platelet prothrombotic potential. Further study of coated-platelet levels in patients with asymptomatic carotid stenosis is warranted to assess for an association with stroke incidence.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.44.suppl_1.AWP146
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2013
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  • 5
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    COATED-PLATELETS ENHANCE TIA/STROKE RISK PREDICTION IN ASYMPTOMATIC CAROTID STENOSIS PATIENTS FOLLOWED WITH CAROTID DOPPLER SURVEILLANCE
    Elsevier BV ; 2021
    In:  Journal of the American College of Cardiology Vol. 77, No. 18 ( 2021-05), p. 1817-
    Details
    In: Journal of the American College of Cardiology, Elsevier BV, Vol. 77, No. 18 ( 2021-05), p. 1817-
    Type of Medium: Online Resource
    ISSN: 0735-1097
    URL: Article
    DOI: 10.1016/S0735-1097(21)03173-9
    RVK:
    XA 17760
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
    detail.hit.zdb_id: 1468327-1
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  • 6
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    Lower Coated-Platelet Levels, RANTES and Fibrinogen Correlate with the Number of Cerebral Microbleeds in Carotid Stenosis (2335)
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Neurology Vol. 94, No. 15_supplement ( 2020-04-14)
    Details
    In: Neurology, Ovid Technologies (Wolters Kluwer Health), Vol. 94, No. 15_supplement ( 2020-04-14)
    Type of Medium: Online Resource
    ISSN: 0028-3878 , 1526-632X
    URL: Article
    DOI: 10.1212/WNL.94.15_supplement.2335
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
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  • 7
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    Online Resource
    Abstract W P405: Association Between Coated-Platelet Levels and MCP-1 Among Patients with Asymptomatic Carotid Stenosis
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Stroke Vol. 46, No. suppl_1 ( 2015-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 46, No. suppl_1 ( 2015-02)
    Abstract: Background: Extensive data support the link between inflammation and stroke. Coated-platelets, a subset of platelets with high procoagulant potential observed upon dual agonist stimulation with collagen and thrombin, are elevated in acute ischemic stroke also identify asymptomatic carotid stenosis patients at high risk for stroke or TIA. Because inflammation may be involved in coated-platelet synthesis, we explored whether inflammatory markers are associated with coated-platelet levels in with asymptomatic carotid atherosclerosis. Methods: Coated-platelet levels were assayed for 124 asymptomatic patients referred for carotid Doppler evaluation. Serum was obtained simultaneously for measurement of inflammatory markers using the Bio-Plex Pro Human Cytokine 27-plex Assay kit (Bio-Rad Laboratories). Hs-CRP was also measured. Inflammatory markers were analyzed as independent variables according to quartiles of marker concentration with coated-platelet levels as a continuous dependent variable. Backward stepwise regression was conducted to find the best combination of predictors of coated-platelet levels. Markers having bivariate correlations with coated-platelet levels at the 0.25 significance level were included as potential predictors. Relevant demographic and comorbid factors were also considered. Variables with p values 〈 0.05 were retained in the final model. Results: Bivariate analysis revealed significant correlations between coated-platelet levels and IL-7 (r= -0.22, p=0.013) and MCP-1 (r= -0.22, p=0.013). These and 7 variables correlating with coated-platelet levels at p≤0.25 (IL-10, IL-13, IL-5, IP-10, MIP-1b, RANTES, and previous stroke/TIA) were assessed using stepwise multiple regression analysis. MCP-1 was the only variable retained in the model (b= -2.99, SE=1.2, F=6.20, p=0.015, R2=0.062). Conclusions: There was a statistically significant inverse association between MCP-1 and coated-platelets, although the effect size was modest. These findings suggest that the role played by inflammation in coated-platelet synthesis, as assessed with currently available markers, is small. Thus, other mechanisms coated-platelet potential determination should be explored.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.46.suppl_1.wp405
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
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  • 8
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    Abstract 223: Elevated Mip-1b, Peripheral Arterial Disease, and Antiplatelet Medication Use Predict Cognitive Function Among Asymptomatic Patients Referred for Carotid Doppler Evaluation
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Stroke Vol. 46, No. suppl_1 ( 2015-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 46, No. suppl_1 ( 2015-02)
    Abstract: Background: Vascular cognitive impairment (VCI) includes the entire spectrum of cognitive disorders associated with cerebrovascular disease, ranging from mild cognitive impairment to vascular dementia. Our incomplete understanding of vascular and inflammatory mechanisms involved limits the ability to prevent cognitive impairment. We explored whether inflammation may be associated with cognitive function among subjects at risk for cerebrovascular disease. Methods: Sixty consecutive patients without dementia or stroke referred for carotid Doppler evaluation were screened for cognitive impairment using the Montreal Cognitive Assessment (MoCA). Serum was obtained for measurement of inflammatory markers using the Bio-Plex Pro Human Cytokine 27-plex Assay kit (Bio-Rad Laboratories). Hs-CRP was also measured. Inflammatory markers were analyzed according to quartiles of marker concentration for association with MoCA score. Backward stepwise regression was conducted to find the best combination of predictors. Markers having bivariate correlations at the 0.25 significance level were included as potential predictors. Relevant demographic and comorbid factors were also considered. Variables with p values 〈 0.05 were retained in the final model. Results: Fifty-eight percent of patients (35/60) had cognitive impairment (MoCA 〈 26, range 19-25). Stepwise multiple regression analysis revealed inverse correlations between three variables and MoCA scores: Macrophage Inflammatory Protein-1b - MIP-1b (b= -0.99, SE = 0.30, p=0.0016), use of antiplatelet medications (b= -1.96, SE = 0.93, p=0.039), and peripheral arterial disease - PAD (b= -1.53, SE = 0.73, p=0.041), overall model R2 = 0.26, F = 6.5, p=0.0007. Conclusions: Elevated MIP-1b, presence of PAD, and use of antiplatelet medications were associated with lower cognitive performance among patients at risk for cerebrovascular disease. The range of abnormal MoCA scores (19-25) and high prevalence of vascular risk factors among this group suggest that the cognitively impaired subjects have early VCI. These data suggest that MIP-1b should be further explored as a potential link to mechanisms for development of VCI.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.46.suppl_1.223
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
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  • 9
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    Abstract 168: Coated-Platelets Improve TIA/Stroke Prediction in Asymptomatic Internal Carotid Artery Stenosis
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Stroke Vol. 45, No. suppl_1 ( 2014-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 45, No. suppl_1 ( 2014-02)
    Abstract: Background: Coated-platelets, a subset of procoagulant platelets observed upon dual agonist stimulation with collagen and thrombin, support a robust prothrombinase activity and provide a unique measure of platelet thrombotic potential. Coated-platelet levels are increased in large artery stroke compared to controls, and higher levels are associated with early stroke recurrence. We now examine whether coated-platelet levels predict TIA/stroke in asymptomatic internal carotid artery (ICA) stenosis. Methods: Consecutive patients referred for carotid Doppler evaluation were enrolled. Those taking anticoagulants, with dementia, or TIA/stroke within 6 months before enrollment were excluded. Coated-platelets were determined at baseline and reported as percent of cells converted to coated-platelets. Subjects were followed for up to 3 years for TIA/stroke. A receiver operating characteristic curve (ROC) analysis was conducted to compare performance of two models in predicting incident TIA/stroke. The first model included stenosis severity ( 〈 70% or ≥70%) while the second model included stenosis severity ( 〈 50% or ≥50%) and coated-platelet level as predictors. Results: We enrolled 343 patients. Follow-up ranged from 4 days to 39.7 months (mean 10.6 months). Fourteen TIA/strokes were observed. Ten were carotid-related. ROC analysis showed significant improvement in the predictive ability of the stenosis (≥50%) plus coated-platelets model compared to the stenosis (≥70%) only model (AUC: 0.88 ± 0.05 versus 0.71 ± 0.08, respectively; p=0.05). A cut-off of 46.5% for coated-platelet levels in combination with stenosis ≥50% yielded a sensitivity of 0.70 (0.42-0.98; 95% CI), specificity of 0.91 (0.88-0.94), positive predictive value of 0.18 (0.06-0.31), and a negative predictive value of 0.99 (0.98-1.0). Coated-platelet levels at 6 months did not significantly differ from baseline (p=0.69). Conclusions: Coated-platelet levels identify asymptomatic ICA stenosis patients at low risk for carotid-related stroke, which suggests a role for coated-platelets in risk stratification prior to revascularization.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.45.suppl_1.168
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
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  • 10
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    Abstract T MP116: Coated-Platelets Predict Stroke at 30 days in Patients with Transient Ischemic Attack
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Stroke Vol. 46, No. suppl_1 ( 2015-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 46, No. suppl_1 ( 2015-02)
    Abstract: Background: Coated-platelets, a subset of procoagulant platelets observed upon dual agonist stimulation with collagen and thrombin, support a robust prothrombinase activity and provide a unique measure of platelet thrombotic potential. Coated-platelet levels are increased both in non-lacunar stroke and transient ischemic attack (TIA) compared to controls free of stroke or TIA. In addition, higher levels in non-lacunar stroke are associated with stroke recurrence. We now examine whether coated-platelet levels predict stroke at 30 days in TIA patients. Methods: Consecutive patients with a diagnosis of TIA established by a board certified neurologist were enrolled in this pilot study. The diagnosis was consistent with the tissue-based definition of TIA: a transient episode of neurological dysfunction without acute infarction. The absence of infarction was demonstrated by normal brain imaging studies. Those taking anticoagulants or with dementia were excluded. Coated-platelets were determined at baseline and reported as percent of cells converted to coated-platelets. A receiver operating characteristic curve (ROC) analysis was conducted to compare the ability of coated-platelets versus chance alone to predict incident stroke at 30 days. Results: We enrolled 171 patients. Ten strokes were observed at 30 days. ROC analysis showed significant improvement in the predictive ability of the coated-platelets model compared to chance (AUC: 0.78 ± 0.07 versus 0.50 ± 0, respectively; p 〈 0.0001). A cut-off of 51.1% for coated-platelet levels yielded a sensitivity of 0.80 (0.55-1.0; 95% CI), specificity of 0.73 (0.66-0.80), positive predictive value of 0.16 (0.06-0.26), and a negative predictive value of 0.98 (0.96-1.0). Conclusions: Among these subjects with TIA, coated platelet levels 〈 51.1% at time of presentation had a negative predictive value of 98% for stroke at 30 days. These findings suggest a role for coated-platelets in stroke risk stratification following TIA.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.46.suppl_1.tmp116
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
    detail.hit.zdb_id: 1467823-8
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