Background and Purpose-Coated platelets are produced on dual agonist stimulation with collagen and thrombin. These highly procoagulant platelets are critical to normal hemostasis, and an earlier study demonstrated decreased coated platelet production in patients with spontaneous intracerebral hemorrhage. We have expanded this observation to investigate if coated platelet levels correlate with bleed volume in spontaneous intracerebral hemorrhage. Methods-Coated platelet levels and bleed volume were determined in 45 patients with a diagnosis of spontaneous intracerebral hemorrhage. Results-There was an inverse relationship between coated platelet levels and bleed volume (rϭϪ0.38, Pϭ0.01). Conclusions-These data support a link between decreased coated platelet synthesis and the severity of spontaneous intracerebral hemorrhage. (Stroke. 2010;41:1301-1303.)Key Words: hemorrhage Ⅲ intracerebral stroke Ⅲ platelets C oated platelets are a subpopulation of platelets observed on dual-agonist stimulation with thrombin and collagen. 1 The biochemical characteristics of coated platelets include a robust prothrombinase activity, retention of several procoagulant proteins on the cell surface, and release of microparticles. 1,2 The critical nature of coated platelets in hemostasis is revealed by a genetic disorder in dogs, in which deficiency of coated platelets results in spontaneous mucosal bleeding and postsurgical hemorrhage. 3 Previous studies in ischemic stroke indicated that coated platelet levels are elevated in patients with nonlacunar stroke as compared with control subjects, a finding in keeping with the thrombotic nature of these events. 4 In contrast, coated platelet production in patients with spontaneous intracerebral hemorrhage (SICH) is decreased when compared with control subjects. 5 We now sought to investigate if the level of coated platelets relates to the bleed volume observed in patients with SICH.
Materials and MethodsForty-five consecutive patients, 15 women and 30 men, with a diagnosis of SICH were recruited from the Neurology Service at the University of Oklahoma Health Sciences Center and the Veterans Affairs Medical Center. All patients were diagnosed with SICH by a board-certified neurologist and underwent brain CT at presentation. 6 A neuroradiologist provided a definitive reading for every scan obtained. We excluded patients with concurrent use of anticoagulation; prolonged prothrombin time, partial thromboplastin time, or international normalized ratio; prior dementia 7 ; Ͼ96 hours between the onset of the symptoms and enrollment 1 ; or hemorrhage secondary to trauma, tumor, hemorrhagic transformation of cerebral infarct, rupture of an aneurysm, or vascular malformation. The percentage of men in our study is a result of the composition of the US Armed Forces during the time these veterans served.Bleed volume was determined on admission from the CT scan by using the ABC/2 formula in which A is the greatest diameter on the largest hemorrhage slice, B is the diameter perpendicular to A, and C is th...