Araştırma Makalesi
PDF Zotero Mendeley EndNote BibTex Kaynak Göster

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

Yıl 2021, Cilt 11, Sayı 6, 900 - 904, 20.11.2021
https://doi.org/10.16899/jcm.867170

Öz

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.

Kaynakça

  • Simon RS, Aminoff AJ, Greenberg DA. Clinical Neurology, 10th edition. . McGraw-Hill Education. 2018
  • Choi D-H, Kang S-H, Song H. Mean platelet volume: a potential biomarker of the risk and prognosis of heart disease. Korean J Intern Med. 2016;31(6):1009-17.
  • Sadeghi F, Kovács S, Zsóri KS, Csiki Z, Bereczky Z, Shemirani AH. Platelet count and mean volume in acute stroke: a systematic review and meta-analysis. Platelets. 2019:1-9.
  • Ranjith MP, DivyaRaj R, Mathew D, George B, Krishnan MN. Mean platelet volume and cardiovascular outcomes in acute myocardial infarction. Heart Asia. 2016;8(1):16-20.
  • Park Y, Schoene N, Harris W. Mean platelet volume as an indicator of platelet activation: methodological issues. Platelets. 2002;13(5-6):301-6.
  • Grotto HZW, Noronha JFA. Platelet larger cell ratio (P-LCR) in patients with dyslipidemia. Clinical & Laboratory Haematology. 2004;26(5):347-9.
  • Rechciński AJT, Foryś J, Krzemińska-Pakuła M, et al. Prognostic value of platelet indices after acute myocardial infarction treated with primary percutaneous coronary intervention. Cardiol J 2013;20(5):491-8.
  • Dehghani MR, Taghipour-Sani L, Rezaei Y, Rostami R. Diagnostic importance of admission platelet volume indices in patients with acute chest pain suggesting acute coronary syndrome. Indian Heart J. 2014;66(6):622-8.
  • Reeves MJ, Bushnell CD, Howard G, et al. Sex differences in stroke: epidemiology, clinical presentation, medical care, and outcomes. Lancet Neurol. 2008;7(10):915-26.
  • Haast RAM, Gustafson DR, Kiliaan AJ. Sex differences in stroke. J Cereb Blood Flow Metab. 2012;32(12):2100-7.
  • Girijala RL, Sohrabji F, Bush RL. Sex differences in stroke: Review of current knowledge and evidence. Vascular Medicine. 2016;22(2):135-45.
  • Khandekar MM, Khurana AS, Deshmukh SD, Kakrani AL, Katdare AD, Inamdar AK. Platelet volume indices in patients with coronary artery disease and acute myocardial infarction: an Indian scenario. Journal of Clinical Pathology. 2006;59(2):146.
  • Cerit L, Cerit Z. Relationship between coronary tortuosity and plateletcrit coronary tortuosity and plateletcrit. Cardiovasc J Afr. 2017;28(6):385-8.
  • De Luca G, Santagostino M, Secco GG, et al. Platelet-Large Cell Ratio and the extent of coronary artery disease: results from a large prospective study. Journal of Thrombosis and Thrombolysis. 2010;30(4):426-33.
  • Verdoia M, Barbieri L, Schaffer A, et al. Platelet–larger cell ratio and the risk of periprocedural myocardial infarction after percutaneous coronary revascularization. Heart and Vessels. 2015;30(1):20-7.

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

Yıl 2021, Cilt 11, Sayı 6, 900 - 904, 20.11.2021
https://doi.org/10.16899/jcm.867170

Öz

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.

Kaynakça

  • Simon RS, Aminoff AJ, Greenberg DA. Clinical Neurology, 10th edition. . McGraw-Hill Education. 2018
  • Choi D-H, Kang S-H, Song H. Mean platelet volume: a potential biomarker of the risk and prognosis of heart disease. Korean J Intern Med. 2016;31(6):1009-17.
  • Sadeghi F, Kovács S, Zsóri KS, Csiki Z, Bereczky Z, Shemirani AH. Platelet count and mean volume in acute stroke: a systematic review and meta-analysis. Platelets. 2019:1-9.
  • Ranjith MP, DivyaRaj R, Mathew D, George B, Krishnan MN. Mean platelet volume and cardiovascular outcomes in acute myocardial infarction. Heart Asia. 2016;8(1):16-20.
  • Park Y, Schoene N, Harris W. Mean platelet volume as an indicator of platelet activation: methodological issues. Platelets. 2002;13(5-6):301-6.
  • Grotto HZW, Noronha JFA. Platelet larger cell ratio (P-LCR) in patients with dyslipidemia. Clinical & Laboratory Haematology. 2004;26(5):347-9.
  • Rechciński AJT, Foryś J, Krzemińska-Pakuła M, et al. Prognostic value of platelet indices after acute myocardial infarction treated with primary percutaneous coronary intervention. Cardiol J 2013;20(5):491-8.
  • Dehghani MR, Taghipour-Sani L, Rezaei Y, Rostami R. Diagnostic importance of admission platelet volume indices in patients with acute chest pain suggesting acute coronary syndrome. Indian Heart J. 2014;66(6):622-8.
  • Reeves MJ, Bushnell CD, Howard G, et al. Sex differences in stroke: epidemiology, clinical presentation, medical care, and outcomes. Lancet Neurol. 2008;7(10):915-26.
  • Haast RAM, Gustafson DR, Kiliaan AJ. Sex differences in stroke. J Cereb Blood Flow Metab. 2012;32(12):2100-7.
  • Girijala RL, Sohrabji F, Bush RL. Sex differences in stroke: Review of current knowledge and evidence. Vascular Medicine. 2016;22(2):135-45.
  • Khandekar MM, Khurana AS, Deshmukh SD, Kakrani AL, Katdare AD, Inamdar AK. Platelet volume indices in patients with coronary artery disease and acute myocardial infarction: an Indian scenario. Journal of Clinical Pathology. 2006;59(2):146.
  • Cerit L, Cerit Z. Relationship between coronary tortuosity and plateletcrit coronary tortuosity and plateletcrit. Cardiovasc J Afr. 2017;28(6):385-8.
  • De Luca G, Santagostino M, Secco GG, et al. Platelet-Large Cell Ratio and the extent of coronary artery disease: results from a large prospective study. Journal of Thrombosis and Thrombolysis. 2010;30(4):426-33.
  • Verdoia M, Barbieri L, Schaffer A, et al. Platelet–larger cell ratio and the risk of periprocedural myocardial infarction after percutaneous coronary revascularization. Heart and Vessels. 2015;30(1):20-7.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Bilimleri ve Hizmetleri
Bölüm Orjinal Araştırma
Yazarlar

Mehmet Nuri KOÇAK
ATATÜRK ÜNİVERSİTESİ, TIP FAKÜLTESİ
0000-0003-0828-520X
Türkiye


Mustafa BAYRAKTAR (Sorumlu Yazar)
ATATÜRK ÜNİVERSİTESİ, TIP FAKÜLTESİ
0000-0001-8486-9915
Türkiye


Muhammet ÇELİK
ATATÜRK ÜNİVERSİTESİ, TIP FAKÜLTESİ
0000-0002-9536-8101
Türkiye


Erdal TEKİN
ATATÜRK ÜNİVERSİTESİ, TIP FAKÜLTESİ
0000-0002-6158-0286
Türkiye

Destekleyen Kurum Yoktur.
Yayımlanma Tarihi 20 Kasım 2021
Kabul Tarihi 8 Ekim 2021
Yayınlandığı Sayı Yıl 2021, Cilt 11, Sayı 6

Kaynak Göster

AMA Koçak M. N. , Bayraktar M. , Çelik M. , Tekin E. Differential Diagnosis of Stroke by Platelet Large Cell Ratio (P-LCR) Levels. J Contemp Med. 2021; 11(6): 900-904.