Time Course of Platelet Activation and von Willebrand Factor in Patients With Non-Valvular Atrial Fibrillation After Ischemic Stroke : Evaluation of Prognostic Determinants

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Background The present study investigated serial changes in platelet activation(expressed by CD62p) and von Willebrand factor(VWF), and the correlation between increased CD62p expression, VWF and brain infarct volume(BIV: measured by magnetic resonance imaging), and prognostic determinants in non-valvular atrial fibrillation(NVAF) patients after acute ischemic stroke(IS). Methods and Results CD62p expression and plasma VWF concentrations were serially measured(<48h, on days 7, 21 and 90) using flow cytometry and enzyme-linked immunosorbent assay, respectively after acute IS in 61 NVAF patients. CD62p expression and VWF concentrations were also examined in 50 NVAF-risk control and 30 healthy individuals. The VWF concentration had no significant changes at 4 intervals among the patients and did not differ among 3 groups at acute stroke phase. CD62p expression was significantly higher in the acute phase after IS than in both control groups(both p<0.0001). However, CD62p expression declined to a significantly lower level on day 7 and to a substantially lower level thereafter(p<0.0001). CD62p expression did not differ on day 90 in the 3 groups(both p>0.5). Linear regression analysis showed that BIV and modified Rankin scale score(>3) were independently associated with increased CD62p expression(<48h)(both p<0.01). Furthermore, the Cox proportional hazards model showed that BIV was the only independent predictor of intermediate-term(8.8±4.4 months) combined recurrent stroke and death. Conclusions The CD62p expression, which reflected increased BIV, was significantly increased in NVAF patients in acute-phase IS and substantially declined thereafter. The BIV was predictive of unfavorable intermediate-term clinical outcomes.
社団法人日本循環器学会の論文
2007-02-20

Time Course of Platelet Activation and von Willebrand Factor in Patients With Non-Valvular Atrial Fibrillation After Ischemic Stroke : Evaluation of Prognostic Determinants

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