Differential Diagnosis of Stroke by Platelet Large Cell Ratio (P-LCR) Levels

Abstract

Aim: Platelets play an important role in the pathogenesis of thrombosis and atherosclerosis. Platelet Large Cell Ratio (P-LCR), a routine hemogram parameter, is the largest fraction of platelets that are more closely related to thrombotic events. In this study, for the first time in the literature, P-LCR levels in ischemic and hemorrhagic stroke patients were compared with the levels in transient ischemic attack (TIA) group. Method: Retrospectively, hospital records between January 2016 and 2019, were searched by ICD-10 codes, and patients aged between 18-70 years who were diagnosed as ischemic stroke, hemorrhagic stroke and transient ischemic attack were included. The P-LCR test results in the first hemogram test of the patients taken at the time of admission to the hospital were included and compared. Results: Of the 4511 patients, 92.6% (n=4177) were diagnosed with ischemic stroke, 6% (n=271) with hemorrhagic stroke, and 1.4% (n=63) of patients with TIA. The P-LCR levels of the ischemic and hemorrhagic stroke patients were found to be significantly higher than the TIA group (p=0.027; p=0.044, respectively). The Area Under the Curve (AUC) values for ischemic, hemorrhagic and total stroke versus TIA patients were 0.581, 0.568, and 0.580; respectively. The cut-off value of P-LCR was 26.65 ng/L between the ischemic stroke and TIA. Conclusion: The increase in P-LCR levels can be used to distinguish ischemic and hemorrhagic stroke from TIA.

Keywords

• Platelet Large Cell Ratio
• stroke
• ischemic
• hemorrhagic
• Transient ischemic attack

Trombosit Büyük Hücre Oranı (P-LCR) Düzeylerine Göre İnmenin Ayırıcı Tanısı

Abstract

Amaç: Trombositler, tromboz ve ateroskleroz patogenezinde önemli bir rol oynamaktadır. Rutin hemogramda bakılan bir parametre olan trombosit büyük hücre oranı (P-LCR), trombotik olaylarla daha yakından ilişkili olan trombositlerin en büyük fraksiyonunun ölçümüdür. Bu çalışmamızda, literatürde ilk kez, iskemik ve hemorajik inme hastalarında P-LCR seviyeleri geçici iskemik atak (TIA) grubundaki seviyelerle karşılaştırıldı. Yöntem: Retrospektif olarak, Ocak 2016-2019 tarihleri arasındaki hastane kayıtları ICD-10 kodları ile araştırılarak, iskemik inme, hemorajik inme ve geçici iskemik atak tanısı alan 18-70 yaş arası hastalar çalışmaya dâhil edilmiştir. Hastaların hastaneye başvuru anında alınan ilk hemogram testindeki PLCR test sonuçları karşılaştırılmıştır. Bulgular: Çalışmaya dâhil edilen 4511 hastanın, %92,6’sı (n=4177) iskemik inme hastası, %6’sı (n=271) hemorajik inme hastası ve %1,4’ü (n=63) TIA hastası tespit edildi. İskemik ve hemorajik inme hastalarında P-LCR düzeylerinin TIA grubuna göre anlamlı olarak yüksek olduğu bulunmuştur (sırasıyla p=0,027; p = 0,044). İskemik, hemorajik ve total inme hastaları ile TIA hastaları karşılaştırıldığında, eğri altındaki alan (AUC) değerleri sırasıyla 0,581; 0,568 ve 0,580 idi. İskemik inme ve TIA arasında P-LCR kesme değeri 26,65 ng/L idi. Sonuç: P-LCR seviyelerindeki artış, iskemik ve hemorajik inmeyi TIA'dan ayırt etmek için kullanılabilir.

Keywords

• Trombosit Büyük Hücre Oranı
• İnme
• İskemik
• Hemorajik
• Geçici İskemik Atak

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