Platelet Indices and Prognostic Indicators in Ischemic Stroke

Ischaemic stroke remains a leading cause of mortality and long-term disability worldwide. Platelets play a central role in thrombus formation, and quantitative measures of platelet morphology and function have emerged as accessible biomarkers for predicting clinical outcome. Indices such as mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit reflect platelet activation and size heterogeneity, while ratios combining platelet counts with leucocyte or other inflammatory markers—such as the platelet-to-lymphocyte ratio (PLR) and the white blood cell to mean platelet volume ratio (WMR)—capture systemic inflammatory responses. Higher MPV and PDW have been linked to larger infarct volumes, greater neurological deficit on admission and poorer functional recovery at three months. Integrative models incorporating platelet indices alongside age, baseline National Institutes of Health Stroke Scale (NIHSS) score and imaging features have demonstrated improved risk stratification, enabling more tailored therapeutic decisions. Globally, such prognostic tools have potential applications in acute care triage, post-thrombectomy management and resource allocation, particularly in settings with limited imaging infrastructure.

Research from Nature Portfolio

Recent studies have leveraged high-resolution platelet phenotyping and multi-omic integration to refine prognostic signatures in acute ischaemic stroke. One investigation applied single-cell analysis of circulating platelets and demonstrated that a composite score of platelet activation markers predicted 90-day functional outcome independent of recanalization status. Another work developed a multi-modal risk model combining platelet indices, proteomic profiles and advanced imaging metrics, which outperformed conventional clinical scales in forecasting early neurological deterioration. These advances underline the growing potential of integrating detailed platelet biology with clinical parameters to enhance prognostic accuracy and inform personalised interventions.

Platelet Indices and Prognostic Indicators in Ischemic Stroke publication trend

The graph below shows the total number of articles in platelet indices and prognostic indicators in ischemic stroke across all publications each year (not limited to Nature Index journals).

Technical terms

Mean platelet volume (MPV): Measure of average platelet size, indicating activation status.

Platelet distribution width (PDW): Statistical dispersion of platelet size, reflecting heterogeneity.

Plateletcrit: Volume percentage of platelets in blood, analogous to haematocrit for red cells.

Platelet-to-lymphocyte ratio (PLR): Ratio of platelet count to lymphocyte count, marker of inflammation.

White blood cell to mean platelet volume ratio (WMR): Ratio combining total leucocyte count with MPV for prognostic assessment.

National Institutes of Health Stroke Scale (NIHSS): Clinical tool quantifying neurological deficit in stroke patients.

Modified Rankin Scale (mRS): Scale measuring degree of disability or dependence after stroke.

References

1. The white blood cell count to mean platelet volume ratio for ischemic stroke patients after intravenous thrombolysis. Frontiers in Immunology (2022).
2. The Role of the Multi-Inflammatory Index as a Novel Predictor of Hospital Mortality in Acute Ischemic Stroke. Cureus (2023).
3. Prediction of Poor Outcome after Successful Thrombectomy in Patients with Severe Acute Ischemic Stroke: A Pilot Retrospective Study. Neurology International (2023).
4. Relationship between baseline mean platelet volume (MPV) and prognosis of patients with acute mild cerebral infarction undergoing intravenous thrombolysis with Alteplase. Pakistan Journal of Medical Sciences (2023).