A prospective cohort study on prognostic implications of serum platelet derived microparticles levels in acute cerebral infarction

Platelet-derived microparticles (PDMPs) participate in ischemic brain injury. We further determined the relationships between serum PDMPs levels and early neurological deterioration (END) as well as functional outcome after acute cerebral infarction (ACI). In this prospective cohort study, serum PDMPs levels were measured in 125 controls and 621 patients with ACI. Univariate analysis and multivariate analysis were sequentially applied to investigate the relations of serum PDMPs levels to END and poor prognosis (modified Rankin scale score > 2) at six months after ACI. Serum PDMPs levels were significantly higher in patients than in controls (median, 14.00 ng/L vs. 27.00 ng/L; P < 0.001). Serum PDMPs levels were strongly correlated with infarction volume (ρ = 0.532, P < 0.001), National Institutes of Health Stroke Scale score (ρ = 0.627, P < 0.001) and modified Rankin scale score (ρ = 0.528, P < 0.001). It was independently associated with END [odds ratio (OR) 1.117, 95% confidence interval (CI) 1.008-1.238; P = 0.001] and poor prognosis (OR 1.092, 95% CI 1.066-1.119; P = 0.001). There were linear relationships between serum PDMPs levels and risks of poor prognosis (P for non-linear = 0.055) plus END (P for non-linear = 0.061) under restricted cubic spline. Using subgroup analysis, significant interaction existed between serum PDMPs levels and age in association of poor prognosis (P for interaction = 0.006), as well as between serum PDMPs levels and coronary heart disease in association of END (P for interaction = 0.017). Serum PDMPs levels significantly discriminated the development of poor prognosis (Area under curve 0.705, 95% CI 0.632-0.778; P < 0.001) and END (The area 0.733, 95% CI 0.664-0.803; P < 0.001). Serum PDMPs levels may predict the risk of END and 6-month poor prognosis in patients with ACI.