Profile of reticulated platelets in the early, subacute and late phases after transient ischemic attack or ischemic stroke

Abstract

Information regarding the profile of reticulated platelets (RP) in ischemic cerebrovascular disease (CVD) patients is limited. Data from two prospective, observational, case-control studies were combined to compare the %RP using whole blood flow cytometry in patients ≤ 4 weeks of TIA/stroke onset (baseline, N = 210), and 14 ±7 days (14d, N = 182) and ≥ 90 days (90d, N = 145) after starting or changing antiplatelet therapy with healthy controls (N = 34). There were no differences in median %RP between the overall CVD patient population at baseline or 14d vs. controls (P ≥ 0.2). However, the median %RP was significantly higher in CVD patients overall at 90d (P = .036), and in the subgroup of patients with “lacunar” TIA/ischemic stroke at baseline (P = .04) and at 90d (P = .01), but not at 14d (P = .06) vs. controls. There were no significant differences in the median %RP between other TIA/stroke subgroups and controls (P ≥ 0.05). Elevated circulating reticulated platelets, as a marker of increased platelet production/turnover, may occur following an ischemic event in a well-phenotyped TIA/ischemic stroke population overall, but may precede symptom onset at least in the subgroup with small vessel occlusion. These data improve our understanding of the profile of reticulated platelets in CVD patients.

Keywords:

• Flow cytometry
• ischemic stroke
• mean platelet volume
• platelet distribution width
• reticulated platelets
• TIA

Acknowledgements and Funding

All collaborators qualified for authorship because they contributed to study design, data acquisition or analysis, and all critically appraised and approved the final submitted manuscript for important intellectual content. Dr. Lim’s research was funded by The Meath Foundation, The Irish Institute of Clinical Neuroscience/Novartis Ireland Fellowship Grant, The Vascular Neurology Research Foundation, Ireland, the Irish Heart Foundation Stroke Prevention Bursary programme, and by an unrestricted educational grant from Biogen Idec, Ireland and Verum Diagnostica, GmbH. Dr. Murphy’s research was funded by the Trinity College Dublin Innovation Bursary, The Meath Foundation, Ireland, Joint Irish Institute of Clinical Neuroscience/Merck Serono Fellowship in Neuroscience Grant, The Vascular Neurology Research Foundation, Ireland, and by an unrestricted educational grant from Bayer HealthCare, Ireland. Dr. Smith’s research was funded by The Vascular Neurology Research Foundation, Ireland. None of the above charities or funding bodies had any influence on the design or conduct of this study, or had any influence on the decision to submit the final manuscript for publication. The manuscript has not been submitted elsewhere and has not been published elsewhere in whole or in part, except as an abstract.

Declaration of Interest

The authors have no conflicts of interest to declare.