Association of Mean Platelet Volume with Acute Ischemic Cerebrovascular Accident Among Patients with Type 2 Diabetes Mellitus: A Hospital-Based Study

摘要

Objective: To study the association of MPV (mean platelet volume) and acuteischemic stroke in patients of type 2 diabetes mellitus (DM).Methods: This was a 1-year cross-sectional hospital-based study involving 79patients presented with acute ischemic stroke. Among them, 25 were diabeticand 54 were nondiabetic. Demographic data and history of the patients wererecorded. Investigations such as haemoglobin estimation, platelet count, MPV,HbA1c, imaging studies were conducted and evaluated for acute ischemic brainstroke. All the patients underwent neurological examination according to NationalInstitute of Health Stroke Scale (NIHSS) at the time of admission and MPV wasnoted. Outcome of stroke was assessed during discharge by modified Rankinmorbidity (MRM) score. SPSS 20 was used to analyse the data.Results: Among 79 them, 25 patients (31.6%) had history of diabetes whichformed the diabetic subset and the remaining 54 (68.35%) were considered innon-diabetic subset. MPV in patients with DM was significantly high (10.16 ± 0.89fL) compared to nondiabetic patients (8.25 ± 0.91 fL; p0.001). The mean NIHSSscores were significantly high in patients with diabetes compared to nondiabeticpatients (20.38±3.19 vs. 17.76±3.74; p=0.006). Also, the mean MRM scores weresignificantly high in diabetics than that of nondiabetics (4.12 ± 0.66 vs. 3.00 ±0.61; p0.001). History of stroke was present in 12% of patients with DM comparedto 1.85% of the non-diabetic patients (p=0.091).Conclusions: Acute ischemic stroke in diabetic patients is significantly associatedwith raised MPV level, which is likely to be severe with high morbidity andmortality. Hence, MPV is an easily available blood parameter, which definesplatelet reactivity and proves to be a good predictor of severity and outcomeof stroke in diabetics. Also, higher percentile of patients showed history ofrecurrent stroke in diabetics as compared to non-diabetics in whom the MPVwas considerably raised compared to other diabetic stroke cases.