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

OBJECTIVE

To study the association of MPV (mean platelet volume) and acute ischemic stroke in patients of type 2 diabetes mellitus (DM).

MATERIAL

This was a 1-year cross-sectional hospital-based study involving 79 patients presented with acute ischemic stroke. Among them, 25 were diabetic and 54 were nondiabetic. Demographic data and history of the patients were recorded. Investigations such as haemoglobin estimation, platelet count, MPV, HbA1c, imaging studies were conducted and evaluated for acute ischemic brain stroke. All the patients underwent neurological examination according to National Institute of Health Stroke Scale (NIHSS) at the time of admission and MPV was noted. Outcome of stroke was assessed during discharge by modified Rankin morbidity (MRM) score. SPSS 20 was used to analyse the data.

RESULTS

Among 79 them, 25 patients (31.6%) had history of diabetes which formed the diabetic subset and the remaining 54 (68.35%) were considered in non-diabetic subset. MPV in patients with DM was significantly high (10.16 ± 0.89 fL) compared to nondiabetic patients (8.25 ± 0.91 fL; p<0.001). The mean NIHSS scores were significantly high in patients with diabetes compared to nondiabetic patients (20.38±3.19 vs. 17.76±3.74; p=0.006). Also, the mean MRM scores were significantly high in diabetics than that of nondiabetics (4.12 ± 0.66 vs. 3.00 ± 0.61; p<0.001). History of stroke was present in 12% of patients with DM compared to 1.85% of the non-diabetic patients (p=0.091).

CONCLUSION

Acute ischemic stroke in diabetic patients is significantly associated with raised MPV level, which is likely to be severe with high morbidity and mortality. Hence, MPV is an easily available blood parameter, which defines platelet reactivity and proves to be a good predictor of severity and outcome of stroke in diabetics. Also, higher percentile of patients showed history of recurrent stroke in diabetics as compared to non-diabetics in whom the MPV was considerably raised compared to other diabetic stroke cases.