Abstract
Background
Coated-platelets are procoagulant platelets observed upon dual agonist stimulation
with collagen and thrombin. Coated-platelet levels are elevated in non-lacunar ischemic
stroke compared to either lacunar stroke or controls. In contrast, coated-platelet
levels are decreased in spontaneous intracerebral hemorrhage (ICH) and inversely correlated
with bleed size. We now report the first investigation of coated-platelets in patients
with subarachnoid hemorrhage (SAH).
Methods
Coated-platelet levels were determined in 40 consecutive patients with spontaneous
SAH and in 40 controls. Results are reported as percent of cells converted to coated-platelets.
Mortality at one month was recorded for all patients.
Results
Coated-platelet levels (mean ± SD) were significantly higher in SAH patients compared to controls (41.8 ± 11.4% vs. 30.7 ± 12.2%, p < 0.0001). Among all patients, mortality at 1 month was 20% (8 deaths). Patients were analyzed according to tertiles of coated-platelet
levels (split at <36.7%, 36.7–46.2%, >46.2%). The 1-month mortality differed significantly between the coated-platelet tertiles
(p = 0.01) with 46% mortality (6/13) among patients in the lowest tertile (lowest levels)
compared to 14.3% (2/14) among those in the middle tertile and 0% in the highest tertile.
Conclusions
Coated-platelet levels are higher in SAH patients compared to controls. However, lower
coated-platelet levels are associated with increased 1-month mortality in SAH patients,
a finding compatible with prior observations of an inverse relationship between coated-platelet
levels and bleed volume in ICH. The current data support the role played by these
prothrombotic platelets in thrombosis or hemorrhage and suggest a potential place
for coated-platelet levels in predicting prognosis after SAH.
Keywords
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Article info
Publication history
Published online: August 29, 2013
Accepted:
August 7,
2013
Received in revised form:
July 29,
2013
Received:
April 25,
2013
Identification
Copyright
Published by Elsevier Inc.
