Correlation of platelet function with recurrent ischemic vascular events in stroke patients

Platelet activation and aggregation, as well as thrombosis, play an important role in the pathological and physiological processes of recurrent ischemic vascular events in stroke patients. The purpose of this study is to investigate the correlation of platelet function and recurrent ischemic vascular events in the secondary prevention of stroke. A total of 350 stroke patients within 72 h of onset from September 2014 to April 2015 were included in this study. The patients were administered aspirin starting from the day of admission. After 7-10 days, the platelet aggregation ratio was detected using method with continuous platelet counting, and the baseline data were recorded. The patients underwent a 6-month follow-up period, and the recurrent ischemic vascular events were observed. Logistic regression analysis was performed to obtain the risk factors for recurrent ischemic vascular events and the receiver operating characteristic (ROC) curve. The predictive value of the platelet aggregation ratio by method with continuous platelet counting detection for ischemic vascular events was analyzed. Among the 350 stroke patients, 52 patients had recurrent ischemic vascular events during the follow-up period. The proportion of the patients with recurrent ischemic events who also had diabetes (48.01% vs. 23.15%, P<0.001), low-density lipoprotein (LDL) cholesterol (3.02±0.74 vs. 2.74±0.72, P=0.016), an arachidonic acid-induced maximum platelet aggregation ratio (MAR-AA) (27.31±9.49 vs. 18.85±6.60, P<0.001), and an epinephrine-induced maximum platelet aggregation ratio (MAR-EPI) (61.26±13.02 vs. 51.41±14.81, P<0.001) was significantly higher than that of the patients in the no ischemic vascular event group. These increased parameters were determined to be the independent risk factors for the occurrence of ischemic vascular events in stroke patients. MAR-AA was most closely related to the occurrence of ischemic vascular events (OR=1.133, 95% CI: 1.080~1.188, P<0.001) and showed a good predictive value for ischemic events with an area under the ROC curve (AUC) of 0.803. The increase in MAR-AA was also an independent risk factor for stroke recurrence (OR=1.090, 95% CI: 1.037~1.145, P=0.001). In the secondary prevention of stroke, platelet function measured with the continuous platelet counting method is closely related to recurrent ischemic vascular events; thus, this parameter has a good predictive value for recurrent ischemic vascular events.