(Read Only) Dale_US_Neuro 16/02/2010 09:31 Page 57
Coated-platelets in Ischemic Stroke
within the broad classification of ischemic strokes may partially
explain the relatively modest efficacy of antiplatelets in clinical trials Calin I Prodan, MD, is an Associate Professor in the
for secondary prevention of ischemic stroke.
20
This poor performance
Department of Neurology and an Attending Physician at
the Veterans Affairs Medical Center, University of
is particularly noteworthy compared with the success of antiplatelet
Oklahoma Health Sciences Center. His research has
therapy in secondary prevention of myocardial infarction. recently focused on the role of coated-platelets in stroke
and Alzheimer’s disease.
Summary
Stroke remains a major public health challenge. Even though
important advances in identifying and treating risk factors for stroke
George L Dale, PhD, is a Professor in the Department of
have occurred, the overall rate of stroke remains significant. In this
Medicine at the University of Oklahoma Health Sciences
article we have briefly discussed a potential role for coated-platelets Center. For the past 10 years his research has focused on
in the pathophysiology of ischemic stroke and the implications of
platelet subsets, and his laboratory was responsible for
the first description of coated-platelets.
these findings for modifying future epidemiological studies of stroke.
We suggest that greater attention to stroke subtypes is essential
when considering risk factors and medications aimed at preventing
stroke recurrence. n
1. Rosamond W, Flegal K, Furie K, et al., Heart disease and procoagulant response, J Thromb Haemostasis, 2005;3: intracerebral hemorrhage, Stroke, 2009;40:2578–80.
stroke statistics—2008 update: a report from the American 2185–92. 14. Wardlaw JM, Lewis SC, Keir SL, et al., Cerebral microbleeds
Heart Association Statistics Committee and Stroke Statistics 8. Prodan CI, Joseph PM, Vincent AS, et al., Coated-platelet are associated with lacunar stroke defined clinically and
Subcommittee, Circulation, 2008;117:e25–146. levels are influenced by smoking, aspirin and selective radiologically, independently of white matter lesions, Stroke,
2. Bamford J, Sandercock P, Dennis M, et al., Classification and serotonin reuptake inhibitors, J Thromb Haemostasis, 2006;37:2633–6.
natural history of clinically identifiable subtypes of cerebral 2007;5:2149–51. 15. Fisher CM, Lacunes: small, deep cerebral infarcts, Neurology,
infarction, Lancet, 1991;337:1521–6. 9. Valaydon ZS, Lee P, Dale GL, et al., Increased coated- 1965;15:774–84.
3. Jackson C, Sudlow C, Comparing risks of death and platelet levels in chronic haemodialysis patients, Nephrology, 16. Fisher CM, Pathological observations in hypertensive
recurrent vascular events between lacunar and non-lacunar 2009;14:148–54. cerebral hemorrhage, J Neuropathol Exp Neurol, 1971;30:
infarction, Brain, 2005;128:2507–17. 10. Brooks MB, Catalfamo JL, Friese P, et al., Scott syndrome 536–50.
4. Alberio L, Safa O, Clemetson KJ, et al., Surface expression dogs have impaired coated-platelet formation and calcein 17. Wardlaw JM, What causes lacunar stroke?, J Neurol Neurosurg
and functional characterization of alpha-granule factor V in release but normal mitochondrial depolarization, J Thromb Psychiatry, 2005;76:617–19.
human platelets: effects of ionophore A23187, thrombin, Haemostasis, 2007;5:1972–4. 18. Labovitz DL, Boden-Albala B, Hauser WA, et al., Lacunar
collagen and convulxin, Blood, 2000;95:1694–1702. 11. Prodan CI, Joseph PM, Vincent AS, et al., Coated-platelets in infarct or deep intracerebral hemorrhage: who gets which?
5. Dale GL, Friese P, Batar P, et al., Stimulated platelets use ischemic stroke: differences between lacunar and cortical The Northern Manhattan Study, Neurology, 2007;68:606–8.
serotonin to enhance their retention of procoagulant stroke, J Thromb Haemostasis, 2008;6:609–14. 19. Azarpazhooh MR, Nicol MB, Donnan GA, et al., Patterns of
proteins on the cell surface, Nature, 2002;415:175–9. 12. Prodan CI, Dale GL, Coated-platelets in ischemic stroke – stroke recurrence according to subtype of first stroke event:
6. Szasz R, Dale GL, Thrombospondin and fibrinogen bind potential insight into the etiology of stroke subtypes, the North East Melbourne Stroke Incidence Study
serotonin-derivatized proteins on COAT-platelets, Blood, Int J Stroke, 2008;3:249–50. (NEMESIS), Int J Stroke, 2008;3:158–64.
2002;100:2827–31. 13. Prodan CI, Vincent AS, Padmanabhan R, et al., Coated- 20. Donnan GA, Fisher M, Macleod M, et al., Stroke, Lancet,
7. Dale GL, Coated-platelets: an emerging component of the platelet levels are low in patients with spontaneous 2008;371:1612–23.
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