Study On Platelet Changes After The Treatment Of Acute Nondisabling Cerebrovascular Disease With Ticagrelor

Objective:In recent years,with the continuous improvement of people's living standard,more and more people are exposed to the high risk factors of cerebrovascular diseases,resulting in the increasing prevalence of cerebrovascular diseases.Acute non-disabling ischemic stroke is an early warning of the occurrence of severe ischemic stroke.At the same time,imaging examination may lead to a high probability of missed diagnosis due to the failure to timely detect the lesion,leading to the occurrence of re-stroke and new vascular events.Therefore,it is very important and valuable to find a conventional and rapid indicator for monitoring.So in this study we focus on observe the relationship between recurrent stroke/new vascular events and platelet parameters in patients with acute non-disabling ischemic stroke treated with antiplatelet drugs within 90 days(24h,7days,90days after treatment).Methods:This trial was a multicenter,randomized,blinded evaluation of clinical trials of outcomes.Ranging in 2018.09 to 2019.5,a total of 315 patients were enrolled in this study who had suffered from acute non-disabling ischemic stroke or transient ischemic attack within 24 hours,and these patients is the part be therapyed by Ticagrelor from THE PRINCE STUDY.Meanwhile,45 healthy volunteers from the physical examination center were recruited as control group.We collected this information to analyze the value changes of the platelet count(Plt)?mean platelet volume(MPV)and platelet distribution width(PDW)in circulating blood during the acute infarction of patients with acute ischemic stroke as well as before and after antiplatelet therapy.Multivariate logistic regression was used to analyze the risk factors associated with cerebral infarction,and the correlation between these factors and recurrent stroke and the occurrence of new vascular events after antiplatelet therapy was statistically analyzed.Results:1.MPV and PDW were significantly increased in patients with acute non-disabling ischemic stroke.At the same time,Plt was significantly lower than the control group(P<0.05);2.After Ticagrelor antiplatelet therapy(24h/7d/90d),on the 7th day,the MPV and PDW in the circulating blood of patients with stroke were significantly higher than those without the re-stroke group,difference between the two groups had statistical significance(P<0.05),but there was no statistical difference on the day of treatment(24h)and 90 days after treatment(P>0.05).3.After Ticagrelor antiplatelet therapy(24h/7d/90d-),on the seventh day,the blood circulation of MPV and PDW in the occurrence of new vascular events in patients compare to the patients not present the new vascular events were significantly higher,the difference was statistically significant(P<0.05),but after the treatment,on the day(24 h)and 90 days,there was no obvious statistical significance difference(P>0.05).4.No significant difference was found in platelet parameters MPV and PDW of patients who were divided into groups on whether the patients presented residual platelet hyperreactivity within three months after Ticagrelor antiplatelet therapy(P>0.05).Conclusion:Our results suggest that both MPV and PDW are risk factors for acute ischemic stroke.MPV and PDW level changes can be predicted to the occurrence of re-stroke/new vascular events on the 7th day after antiplatelet therapy.There was no significant difference between the change of new vascular events on the day of treatment and 90 days after treatment.Moreover,there was no statistical significance in whether the residual platelets in the patients presented high reactivity within 3 months after Ticagrelor treatment.