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Adenosine diphosphate-induced platelet aggregation might contribute to poor outcomes in atrial fibrillation-related

Jae-Hyung Choi1, Jae-Kwan Cha1, Jae-Taeck Huh1

  • 1Stroke Center, Dong-A University Hospital, Busan, Korea.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|November 27, 2013
PubMed

Insights

Platelet activation, measured by adenosine diphosphate (ADP)-induced aggregation, is linked to poor outcomes in atrial fibrillation (AF)-related ischemic stroke (IS). Higher ADP-induced platelet aggregation independently predicts worse prognosis in these patients.

Area of Science:

  • Cardiology
  • Neurology
  • Hematology

Background:

  • Systemic atherosclerosis contributes to ischemic damage and cardioembolism in atrial fibrillation (AF)-related ischemic stroke (IS).
  • Platelet activation is a key factor in atherosclerosis, but its specific role in AF-related IS outcomes is not well understood.

Purpose of the Study:

  • To investigate the association between adenosine diphosphate (ADP)-induced platelet aggregation and long-term outcomes in patients with AF-related IS.
  • To identify predictors of poor prognosis following AF-related IS.

Main Methods:

  • Studied 249 patients treated with anticoagulation for AF-related IS.
  • Assessed ADP-induced platelet aggregation using an optic aggregometer 5 days post-admission.
  • Evaluated patient prognoses at 90 days post-IS.

Main Results:

  • ADP-induced platelet aggregation positively correlated with CHA2DS2-VASc scores.
  • Factors associated with poor 90-day outcomes included older age, stroke history, high NIHSS scores, elevated white blood cell counts, high CHA2DS2-VASc scores, and the highest tertile of ADP-induced platelet aggregation.
  • High NIHSS scores, high CHA2DS2-VASc scores, and the highest tertile of ADP-induced platelet aggregation were independently associated with poor outcomes.

Conclusions:

  • Platelet activation, indicated by ADP-induced aggregation, may significantly influence the outcome of AF-related IS.
  • Elevated platelet aggregation is an independent predictor of poor prognosis in patients with AF-related IS.

Keywords:
Platelet aggregationadenosine diphosphateatrial fibrillationischemic stroke

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