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Abstract Details

Platelet Procoagulant Potential and Sex are Predictive of Cognitive Impairment at 12 Months after Lacunar Stroke
Aging, Dementia, and Behavioral Neurology
Aging and Dementia Posters (7:00 AM-5:00 PM)
036
To examine whether coated-platelet levels measured at the time of lacunar stroke predict cognitive impairment at 12 months.  
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 stroke compared to lacunar stroke and controls, and are associated with both lacunar and non-lacunar stroke recurrence. Previously, we have shown that higher coated-platelet levels in non-lacunar stroke are associated with lower MMSE scores.
Consecutive patients with lacunar stroke were enrolled over 38 months. Coated-platelets were determined at the time of the stroke and reported as percent of platelets converted to coated-platelets. Patients with prior dementia were excluded. Cognitive impairment (dementia or mild cognitive impairment) was determined at 12 months. Correlations were calculated between cognitive impairment at 12 months and coated-platelet levels, demographics, medications, vascular risk factors, NIHSS score, silent cerebrovascular disease (silent brain infarcts, white matter hyperintensities, cerebral microbleeds), and recurrent stroke/TIA. Those reaching significance at p≤0.15 were included in a multiple regression analysis model.

We enrolled 109 patients (22 women), with a mean age of 67.9 years (range 38-100), mean coated-platelet levels of 28.3% (range 5.2-69.3) and mean NIHSS score of 3.7 points (range 0-17); 14 patients had cognitive impairment (12.8%). Coated-platelet levels were predictive of cognitive impairment (p=0.007), with the best cut-off at 34.8%. Bivariate associations were observed with education, coated-platelet group (≥34.8% vs <34.8%), sex, CAD, prior TIA, silent brain infarctions, severe white matter hyperintensities, and recurrent stroke/TIA (p≤0.15). The resulting best model for predicting cognitive impairment included coated-platelets (b=1.16, p=0.006), and sex (b=0.82, p=0.02). Rates of cognitive impairment were higher among women than men (27.3% vs 9.3%) and those with coated-platelet levels ≥34.8 (34.6% vs 6.1%).

Findings suggest that platelet procoagulant potential and sex are linked to development of vascular cognitive impairment following lacunar stroke.
Authors/Disclosures
Sergio A. Ramirez-Salazar, MD (Dartmouth Hitchcock Medical Center)
PRESENTER 		Dr. Ramirez-Salazar has nothing to disclose.
Angelia Kirkpatrick Angelia Kirkpatrick has nothing to disclose.
Andrea Vincent Andrea Vincent has received personal compensation for serving as an employee of Vista LifeSciences. The institution of Andrea Vincent has received research support from Medical Technology Enterprise Consortium (MTEC).
Bappaditya Ray, MD (UT Southwestern Medical Center) Dr. Ray has nothing to disclose.
Jim Scott (Ouhsc) No disclosure on file
George Dale George Dale has nothing to disclose.
Calin I. Prodan, MD (Univ of Oklahoma - Neurology Dept) The institution of Dr. Prodan has received research support from US Department of Veterans Affairs (Merit award CX000340).