Platelets, gender and acute cerebral infarction

Journal of Translational Medicine

Micha Milovanovic¹  Marie Eriksson-Franzen¹  Petter Järemo¹ 

[1] Department of Internal Medicine, The Vrinnevi Hospital, Norrköping, 601 82, Sweden

关键词: P-selectin;    Platelets;    Platelet reactivity;    Platelet activation;    Myeloperoxidase;    Inflammation;    Gender;    Flow cytometry;   

Others  :  1235220
DOI  :  10.1186/s12967-015-0630-x

 received in 2015-06-09, accepted in 2015-08-06,  发布年份 2015

【 摘 要 】

Objective

Platelets may well be significant in the pathogenesis of cerebral infarction. Platelets vary substantially according to gender. The scope of our current work is to establish if female and male stroke sufferers differ regarding platelet reactivity.

Patients and methods

73 Consecutive individuals stricken by acute ischemic cerebral infarction (31 females, 42 males) participated. All stroke subtypes were included. Platelet counts was determined electronically. Platelet reactivity i.e. the presence of surface-bound fibrinogen following provocation was analyzed with a flow cytometer. ADP (1.7 μmol/L) and a thrombin receptor agonist (TRAP-6) (57 μmol/L) were the agonists used.

Results

Female stroke sufferers had higher platelet counts (p = 0.013) but their platelets were less reactive. The p values were (p = 0.038) and (p = 0.016) for ADP and TRAP-6, respectively.

Conclusion

The current study demonstrates that women suffering acute cerebral infarction have less reactive platelets. It is concluded that gender affects platelets. Our study indicates that it may be beneficial to individualize platelet inhibition of stroke sufferers according to gender.

【 授权许可】

   
2015 Järemo et al.

【 参考文献 】

• [1]Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ. 2002; 324:71-86.
• [2]Mulley GP, Heptinstall S, Taylor PM, Mitchell JR. ADP-induced platelet release reaction in acute stroke. Thromb Haemost. 1983; 50:524-526.
• [3]Lukasik M, Rozalski M, Luzak B, Michalak S, Kozubski W, Watala C. Platelet activation and reactivity in the convalescent phase of ischaemic stroke. Thromb Haemost. 2010; 103:644-650.
• [4]Järemo P, Eriksson M, Lindahl TL, Nilsson S, Milovanovic M. Platelets and acute cerebral infarctions. Platelets. 2013; 24:407-411.
• [5]McCabe DJ, Harrison P, Mackie IJ, Sidhu PS, Purdy G, Lawrie AS et al.. Platelet degranulation and monocyte-platelet complex formation are increased in the acute and convalescent phases after ischaemic stroke or transient ischaemic attack. Br J Haematol. 2004; 125:777-787.
• [6]Cevik O, Adiguzel Z, Baykal AT, Somay G, Sener A. The apoptotic actions of platelets in acute ischemic stroke. Mol Biol Rep. 2013; 40:6721-6727.
• [7]Järemo P, Milovanovic M, Richter A. Gender and stable angina pectoris: women have greater thrombin-evoked platelet activity but similar adenosine diphosphate-induced platelet responses. Thromb Haemost. 2005; 94:227.
• [8]Johnson M, Ramey E, Ramwell PW. Sex and age differences in human platelet aggregation. Nature. 1975; 253:355-357.
• [9]Faraday N, Goldschmidt-Clermont PJ, Bray PF. Gender differences in platelet GPIIb-IIIa activation. Thromb Haemost. 1997; 77:748-754.
• [10]Becker DM, Segal J, Vaidya D, Yanek LR, Herrera-Galeano JE, Bray PF et al.. Sex differences in platelet reactivity and response to low-dose aspirin therapy. JAMA. 2006; 295:1420-1427.
• [11]Järemo P, Milovanovic M, Buller C, Nilsson S, Winblad B. P-selectin paradox and dementia of the Alzheimer type: circulating P-selectin is increased but platelet-bound P-selectin after agonist provocation is compromised. Scand J Clin Lab Invest. 2013; 73:170-174.
• [12]Milovanovic M, Nilsson E, Järemo P. Relationships between platelets and inflammatory markers in rheumatoid arthritis. Clin Chim Acta. 2004; 343:237-240.
• [13]Järemo P, Shaba A, Kutti J. Some storage characteristics of buffy coats used for the preparation of platelet concentrates. Ann Hematol. 1992; 65:269-273.
• [14]Järemo P, Lindahl TL, Fransson SG, Richter A. Individual variations of platelet inhibition after loading doses of clopidogrel. J Int Med. 2002; 252:233-238.
• [15]Appelros P, Stegmayr B, Terent A. Sex differences in stroke epidemiology. A systematic review. Stroke. 2009; 40:1082-1090.
• [16]Arboix A, García-Eroles L, Massons J, Oliveres M, Targa C. Lacunar infarcts in patients aged 85 years and older. Acta Neurol Scand. 2000; 101:25-29.
• [17]Arboix A, Cartanyà A, Lowak M, García-Eroles L, Parra O, Oliveres M et al.. Gender differences and woman-specific trends in acute stroke: results from a hospital-based registry (1986–2009). Clin Neurol Neurosurg. 2014; 127:19-24.
• [18]Järemo P, Nilsson O. Interleukin-6 and neutrophils are associated with long-term survival after acute myocardial infarction. Eur J Int Med. 2008; 19:330-333.