0338: C-reactive protein and mean platelet volume/platelet count ratio as predictors of ischemic stroke after acute myocardial infarction

PurposeStroke is a serious complication after acute myocardial infarction (AMI) and is associated with an increased risk of death. However, the increased use of evidence-based therapies (ASA, P2Y12 and statins) has reduced the risk of stroke during the last decade. Whereas the pathophysiological mechanisms are not exactly known, increased inflammation and platelet reactivity could play an important role in the occurrence of stroke during the acute phase of MI. We aimed to investigate the relationship between the mean platelet volume (MPV), a parameter of platelet function, the C-reactive protein (CRP), and the occurrence of in-hospital ischemic stroke (IHS) after AMI.MethodsData were obtained from a French regional survey for AMI, including 5976 patients admitted in intensive care unit (ICU) between 2001 and 2010. Patients were divided in 2 groups according to the occurrence of IHS. MPV, platelet count and CRP were routinely measured from blood samples drawn at admission in ICU.Results87 (1.4%) IHS were recorded during the hospitalization period after admission for AMI. After Cox multivariate regression, IHS was independently associated with history of stroke (OR: 2.26, 95% CI: 1.26-4.06, p=0.006), LVEF<40% (OR: 1.74, 95% CI: 1.08-2.81, p=0.002), glycemia (OR: 1.05, 95% CI:1.01-1.08, p=0.008), CRP>10mg/l (OR: 2.56, 95% CI: 1,64-4.01, p<0.001), MPV/Platelet count ratio (OR 1.04, 95% CI: 1.01-1.08, p=0.03) and new onset atrial fibrillation (OR:1.91, 95% CI:1.12-3.24, p=0.02). Patients developing IHS had both an increased 30-day mortality (32.3% vs 8.3%, p<0.001) and 1-year mortality (44.4% vs 13.5%, p