Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Platelet count predicts adverse clinical outcomes after ischemic stroke or TIA: A subgroup analysis of CSNR II
First author：Ming Yang
Corresponding author：Yongjun Wang,Yilong Wang
essential_information
- Person in charge：Ming Yang
- Data Sources： Golden Bridge
- Number of papers：GOLDEN BRIDGE20190185
- Published time：2019-04-12
2019-04-12
Published articles
Journal：Frontiers in Neurology
Publication type: Original Contributions
IF(IF): 4.003
PMID: 31031698 Link To Pubmed Full text Download
Background And Purpose
The clinical significance of platelet count (PC) for ischemic cerebrovascular disease is not well established and further risk stratification according to baseline PC within normal range has not been reported before. We aim to evaluate the prognostic effect of baseline circulating PC within normal range on the risk of long-term recurrent stroke, mortality and functional outcomes after ischemic stroke or TIA.
Method
We derived data of eligible patients with ischemic stroke or TIA from the China National Stroke Registry (CNSR) II. Circulating PC was analyzed within 1 hour after venipuncture using unfrozen samples at each research center. Subjects were divided into quintiles according to baseline PC within normal range (100-450×109/L). Multivariable cox regression and logistic regression were adopted to explore the correlation of baseline PC with recurrent stroke (ischemic or hemorrhagic), all-cause mortality and poor functional outcomes (modified Rankin Scale 3~6) within one-year follow-up.
Conclusion
In ischemic stroke or TIA patients with normal PC, we found a J-shaped relationship of PC with recurrent stroke and mortality, a U-shaped relationship between PC and long-term poor functional outcome, which may qualify PC a readily available independent predictor for long-term recurrent stroke, mortality and poor functional outcome after ischemic stroke or TIA.
Main results
16842 eligible patients were enrolled in this study from the entire cohort of CNSR II. Among them, the average age was 64.7±11.9, 1241(7.4%) had recurrent stroke, 1377(8.2%) died and 3557(21.1%) ended up with poor functional outcomes after one-year follow-up. Compared with the third PC quintile (186-212×109/L), patients in the top quintile (249-450×109/L) presented with increased risk of recurrent stroke (adjusted hazard ratio 1.21, [1.02-1.45]), all-cause mortality (adjusted hazard ratio 1.43, [1.19-1.73]) and poor functional outcome (adjusted odds ratio 1.49, [1.28-1.74]), while patients in the lowest PC quintile(100-155×109/L) undertook higher risk of poor functional outcome (adjusted odds ratio 1.19, [1.02-1.38]).