490 Original article
Mean platelet volume is related with ischemic stroke in patients with sinus rhythm ¨ zkana, Osman Z. Arikb, Mehmet Y. Go¨zu¨karac, Durmus¸ Y. S¸ahind, Bug˘ra O Salih Topale, Onur K. Uysalf, Zafer Elbasand, Tuncay Epc¸elideng, Murat C ¸ aylid and Mustafa Gu¨rd Stroke is the leading cause of disability worldwide. It is known that atrial fibrillation and left atrial enlargement contribute ischemic stroke, and mean platelet volume (MPV) increases in patients with ischemic stroke and atrial fibrillation. We aimed to determine whether higher MPV is associated with ischemic stroke in patients with sinus rhythm. We evaluated 74 patients in sinus rhythm and with ischemic stroke (Group 1) and 90 age-matched and sexmatched healthy individuals as control group (Group 2). After physical and echocardiographic examination, 24–48 h Holter monitoring and complete blood counts were studied. There were no statistically significant differences in age, sex rates, and comorbidities between groups. Left atrial diameter was higher in Group 1 than Group 2 (P U 0.001), but both were in normal range. MPV was significantly higher in Group 1 (P < 0.001) and was an independent determinant [odds ratio (OR): 1.840; P < 0.001; 95% confidence interval (CI) 1.330–2.545] of ischemic stroke with left atrial (OR: 1.138; P U 0.006; 95% CI 1.037–1.248). In conclusion, higher MPV is associated with acute ischemic stroke in patients
with sinus rhythm and without heart failure or left atrial enlargement. MPV and left atrial diameter are independent predictors of ischemic stroke in this patient population. Blood Coagul Fibrinolysis 27:490–493 Copyright ß 2016 Wolters Kluwer Health, Inc. All rights reserved. Blood Coagulation and Fibrinolysis 2016, 27:490–493 Keywords: cerebral infarction, mean platelet volume, sinus rhythm, stroke a
Department of Cardiology, Bucak State Hospital, Burdur, bDepartment of Cardiology, Gu¨mu¨s¸hane State Hospital, Gu¨mu¨s¸hane, cDepartment of Internal Medicine, Mersin State Hospital, Mersin, dDepartment of Cardiology, Adana Numune Training and Research Hospital, Adana, eDepartment of Cardiology, Gazi University Faculty of Medicine, Ankara, fDepartment of Cardiology, Kayseri Training and Research Hospital, Kayseri and and gDepartment of Neurology, Bucak State Hospital, Burdur Turkey ¨ zkan, MD, Specialist of Cardiology, Department of Correspondence to Bug˘ra O Cardiology, Bucak State Hospital, 15300, Burdur, Turkey Tel: +90 506 530 6229; fax: +90 248 325 6104; e-mail: [email protected] Received 5 December 2013 Revised 14 January 2014 Accepted 18 January 2014
Introduction
Methods
Stroke is the leading cause of disability and the second most common cause of death worldwide [1–3]. Most causes of cerebral infarctions consist of cardioembolic stroke, and atrial fibrillation is the most common cause of ischemic stroke [4].
Patient population and study protocol
Mean platelet volume (MPV) is a potentially useful biomarker of platelet activity [5] and obtained without additional costs. The relationship between increased platelet activity and atherosclerotic disease, including stroke, has been well documented [6–8]. It has been shown that high MPV is associated with an increased risk of stroke [9] and is an independent risk factor for stroke [10] in patients with atrial fibrillation. Furthermore, in a previous study Kim et al. [11] showed that left atrium diameter is an independent predictor of stroke in patients without atrial fibrillation. However, in patients with sinus rhythm, the relationship between MPV and stroke was not studied before. Thus, we aimed to investigate the relationship between MPV and stroke in patients with normal left atrium diameter and sinus rhythm. 0957-5235 Copyright ß 2016 Wolters Kluwer Health, Inc. All rights reserved.
We evaluated 74 patients admitted to Bucak State Hospital emergency department with acute ischemic stroke between January 2012 and July 2013 (Group 1) (mean age 68.7 10.9, 47.3% men) and 90 healthy individuals in sinus rhythm without ischemic stroke as control group (Group 2) (mean age 62.7 13.0, 36.7% men). Comprehensive clinical data (including age, sex, and medications) were recorded, 12-lead ECG and 24 or 48 h Holter monitoring (CardioScan; Premier 11, Beijing, China) were evaluated to detect paroxysmal atrial fibrillation, and echocardiographic studies were performed after physical examination. The acute ischemic stroke was demonstrated with diffusion MRI. Patients with a history of renal insufficiency (e.g. serum creatinine level >1.5 mg/dl), cardiac failure (ejection fraction
Mean platelet volume is related with ischemic stroke in patients with sinus rhythm ¨ zkana, Osman Z. Arikb, Mehmet Y. Go¨zu¨karac, Durmus¸ Y. S¸ahind, Bug˘ra O Salih Topale, Onur K. Uysalf, Zafer Elbasand, Tuncay Epc¸elideng, Murat C ¸ aylid and Mustafa Gu¨rd Stroke is the leading cause of disability worldwide. It is known that atrial fibrillation and left atrial enlargement contribute ischemic stroke, and mean platelet volume (MPV) increases in patients with ischemic stroke and atrial fibrillation. We aimed to determine whether higher MPV is associated with ischemic stroke in patients with sinus rhythm. We evaluated 74 patients in sinus rhythm and with ischemic stroke (Group 1) and 90 age-matched and sexmatched healthy individuals as control group (Group 2). After physical and echocardiographic examination, 24–48 h Holter monitoring and complete blood counts were studied. There were no statistically significant differences in age, sex rates, and comorbidities between groups. Left atrial diameter was higher in Group 1 than Group 2 (P U 0.001), but both were in normal range. MPV was significantly higher in Group 1 (P < 0.001) and was an independent determinant [odds ratio (OR): 1.840; P < 0.001; 95% confidence interval (CI) 1.330–2.545] of ischemic stroke with left atrial (OR: 1.138; P U 0.006; 95% CI 1.037–1.248). In conclusion, higher MPV is associated with acute ischemic stroke in patients
with sinus rhythm and without heart failure or left atrial enlargement. MPV and left atrial diameter are independent predictors of ischemic stroke in this patient population. Blood Coagul Fibrinolysis 27:490–493 Copyright ß 2016 Wolters Kluwer Health, Inc. All rights reserved. Blood Coagulation and Fibrinolysis 2016, 27:490–493 Keywords: cerebral infarction, mean platelet volume, sinus rhythm, stroke a
Department of Cardiology, Bucak State Hospital, Burdur, bDepartment of Cardiology, Gu¨mu¨s¸hane State Hospital, Gu¨mu¨s¸hane, cDepartment of Internal Medicine, Mersin State Hospital, Mersin, dDepartment of Cardiology, Adana Numune Training and Research Hospital, Adana, eDepartment of Cardiology, Gazi University Faculty of Medicine, Ankara, fDepartment of Cardiology, Kayseri Training and Research Hospital, Kayseri and and gDepartment of Neurology, Bucak State Hospital, Burdur Turkey ¨ zkan, MD, Specialist of Cardiology, Department of Correspondence to Bug˘ra O Cardiology, Bucak State Hospital, 15300, Burdur, Turkey Tel: +90 506 530 6229; fax: +90 248 325 6104; e-mail: [email protected] Received 5 December 2013 Revised 14 January 2014 Accepted 18 January 2014
Introduction
Methods
Stroke is the leading cause of disability and the second most common cause of death worldwide [1–3]. Most causes of cerebral infarctions consist of cardioembolic stroke, and atrial fibrillation is the most common cause of ischemic stroke [4].
Patient population and study protocol
Mean platelet volume (MPV) is a potentially useful biomarker of platelet activity [5] and obtained without additional costs. The relationship between increased platelet activity and atherosclerotic disease, including stroke, has been well documented [6–8]. It has been shown that high MPV is associated with an increased risk of stroke [9] and is an independent risk factor for stroke [10] in patients with atrial fibrillation. Furthermore, in a previous study Kim et al. [11] showed that left atrium diameter is an independent predictor of stroke in patients without atrial fibrillation. However, in patients with sinus rhythm, the relationship between MPV and stroke was not studied before. Thus, we aimed to investigate the relationship between MPV and stroke in patients with normal left atrium diameter and sinus rhythm. 0957-5235 Copyright ß 2016 Wolters Kluwer Health, Inc. All rights reserved.
We evaluated 74 patients admitted to Bucak State Hospital emergency department with acute ischemic stroke between January 2012 and July 2013 (Group 1) (mean age 68.7 10.9, 47.3% men) and 90 healthy individuals in sinus rhythm without ischemic stroke as control group (Group 2) (mean age 62.7 13.0, 36.7% men). Comprehensive clinical data (including age, sex, and medications) were recorded, 12-lead ECG and 24 or 48 h Holter monitoring (CardioScan; Premier 11, Beijing, China) were evaluated to detect paroxysmal atrial fibrillation, and echocardiographic studies were performed after physical examination. The acute ischemic stroke was demonstrated with diffusion MRI. Patients with a history of renal insufficiency (e.g. serum creatinine level >1.5 mg/dl), cardiac failure (ejection fraction
