PMID- 18927458
OWN - NLM
STAT- MEDLINE
DCOM- 20090106
LR  - 20161122
IS  - 1524-4628 (Electronic)
IS  - 0039-2499 (Linking)
VI  - 39
IP  - 12
DP  - 2008 Dec
TI  - Platelet C4d is associated with acute ischemic stroke and stroke severity.
PG  - 3236-41
LID - 10.1161/STROKEAHA.108.514687 [doi]
AB  - BACKGROUND AND PURPOSE: Platelets bearing complement C4d were recently reported 
      to be 99% specific for a diagnosis of systemic lupus erythematosus (SLE) and 
      associated with neuropsychiatric lupus. We compared the prevalence of platelet 
      C4d and investigated the clinical associations of platelet C4d in patients with 
      acute ischemic stroke. METHODS: We recruited 80 patients hospitalized for acute 
      ischemic stroke. Stroke severity was measured by the National Institutes of 
      Health Stroke Scale (NIH-SS). Infarct volume was determined by MRI. Platelet C4d 
      was measured by flow cytometry. RESULTS: Mean age was 57.9 years (range: 24.6 to 
      86.8 years), 58% were male, and 91% were white. Eight patients (10%) with acute 
      ischemic stroke were platelet C4d-positive, which was significantly higher in 
      prevalence compared to healthy controls (0%, P<0.0001) and non-SLE patients with 
      immune/inflammatory disease (2%, P=0.004). The median NIH-SS score and infarct 
      volume for acute stroke patients were 6 (interquartile range [IQR]: 2 to 13) and 
      3.4 cc (IQR: 1.1 to 16.6), respectively. Platelet C4d-positive patients were more 
      likely to have a severe stroke compared to those with negative platelet C4d 
      (NIH-SS median: 17.5 versus 5, P=0.003). Positive platelet C4d was independently 
      associated with stroke severity (P=0.03) after controlling for age, 
      anticardiolipin antibody (aCL) status, and total anterior circulation of stroke 
      involvement, and also with infarct volume (P=0.005) after controlling for age, 
      aCL status, and old stroke by MRI. CONCLUSIONS: Platelet C4d is associated with 
      severe acute ischemic stroke. Platelet C4d may be a biomarker as well as 
      pathogenic clue that links cerebrovascular inflammation and thrombosis.
FAU - Mehta, Nidhi
AU  - Mehta N
AD  - University of Pittsburgh School of the Health Sciences, University of Pittsburgh, 
      PA, USA.
FAU - Uchino, Ken
AU  - Uchino K
FAU - Fakhran, Saeed
AU  - Fakhran S
FAU - Sattar, M Abdus
AU  - Sattar MA
FAU - Branstetter, Barton F 4th
AU  - Branstetter BF 4th
FAU - Au, Karen
AU  - Au K
FAU - Navratil, Jeannine S
AU  - Navratil JS
FAU - Paul, Barbara
AU  - Paul B
FAU - Lee, Melissa
AU  - Lee M
FAU - Gallagher, Katie M
AU  - Gallagher KM
FAU - Manzi, Susan
AU  - Manzi S
FAU - Ahearn, Joseph M
AU  - Ahearn JM
FAU - Kao, Amy H
AU  - Kao AH
LA  - eng
GR  - K23 AR-051044/AR/NIAMS NIH HHS/United States
GR  - K24 AR-02213/AR/NIAMS NIH HHS/United States
GR  - MO1-RR-00056/RR/NCRR NIH HHS/United States
GR  - R01 AR-46588/AR/NIAMS NIH HHS/United States
GR  - R01 AR-4676402/AR/NIAMS NIH HHS/United States
GR  - R01 HL-074335/HL/NHLBI NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20081016
PL  - United States
TA  - Stroke
JT  - Stroke
JID - 0235266
RN  - 0 (Antibodies, Anticardiolipin)
RN  - 0 (Biomarkers)
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Peptide Fragments)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 80295-50-7 (Complement C4b)
RN  - 80295-52-9 (complement C4d)
SB  - IM
MH  - Acute Disease
MH  - Aged
MH  - Antibodies, Anticardiolipin/blood
MH  - Arthritis, Rheumatoid/blood/complications/immunology
MH  - Biomarkers
MH  - Blood Platelets/*chemistry
MH  - Brain Ischemia/*blood/drug therapy/immunology/pathology
MH  - Cardiovascular Diseases/blood/immunology
MH  - Comorbidity
MH  - Complement C4b
MH  - Female
MH  - Fibrinolytic Agents/therapeutic use
MH  - Humans
MH  - Inflammation/blood/immunology
MH  - Lupus Erythematosus, Systemic/blood/complications/immunology
MH  - Male
MH  - Middle Aged
MH  - Peptide Fragments/*blood
MH  - Platelet Aggregation Inhibitors/therapeutic use
MH  - Rheumatic Diseases/blood/immunology
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Thrombolytic Therapy
EDAT- 2008/10/18 09:00
MHDA- 2009/01/07 09:00
CRDT- 2008/10/18 09:00
PHST- 2008/10/18 09:00 [pubmed]
PHST- 2009/01/07 09:00 [medline]
PHST- 2008/10/18 09:00 [entrez]
AID - STROKEAHA.108.514687 [pii]
AID - 10.1161/STROKEAHA.108.514687 [doi]
PST - ppublish
SO  - Stroke. 2008 Dec;39(12):3236-41. doi: 10.1161/STROKEAHA.108.514687. Epub 2008 Oct 
      16.