ABSTRACT
Objective:To investigate the correlation between mean platelet volume (MPV) and clinical outcome in patients with acute ischemic stroke (AIS) after intravenous thrombolysis.Methods:Consecutive patients with AIS treated with standard dose alteplase intravenous thrombolysis in the Department of Neurology, the Second People's Hospital of Hefei from July 1, 2019 to August 30, 2020 were enrolled retrospectively. The clinical, laboratory, and imaging data of the patients were collected. The modified Rankin Scale was used to evaluate the clinical outcome at 90 d after onset, and a score of >2 was defined as a poor outcome. Multivariate logistic regression model was used to analyze the independent correlation between MPV and clinical outcome. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of MPV for clinical outcome. Results:A total of 104 patients with AIS who received intravenous thrombolytic therapy were included, including 40 males (38.5%), 64 females (61.5%), and their age was 68.7±12.5 years. The baseline median National Institutes of Health Stroke Scale (NIHSS) score was 6 (interquartile range, 4-11), and the time from onset to intravenous thrombolysis was (128.5±55.9) min. Seventy-five patients (72.1%) had a good outcome, 29 (27.9%) had a poor outcome, and there was no death. The baseline NIHSS score, C-reactive protein, MPV, MPV/platelet count ratio and the proportion of patients with anterior circulation infarction in the poor outcome group were significantly higher than those in the good outcome group (all P<0.05). Multivariate logistic regression analysis showed that MPV (odds ratio [ OR] 1.868, 95% confidence interval [ CI] 1.277-2.732; P=0.001) and baseline NIHSS score ( OR 1.199, 95% CI 1.083-1.328; P<0.001) were the independent risk factors for poor outcome. ROC curve analysis showed that the area under the curve for predicting poor outcome was 0.714 (95% CI 0.606-0.821; P=0.001). The optimal cut-off value was 11.25 fl, the predictive sensitivity and specificity were 65.5% and 70.5%, respectively. Conclusions:There was a significant independent correlation between MPV and the clinical outcome in patients with AIS after intravenous thrombolysis. A higher baseline MPV had a certain predictive value for poor outcome.