Background: Mean platelet volume (MPV) is regarded as a marker for thrombosis, atherosclerosis, and in ammation in various vascular diseases including stroke. However, it is still unclear whether plasma MPV is associated with cerebral white matter hyperintensities (WMH) and cerebral microvascular pathology in the elderly.Methods: We examined whether MPV level is associated with the presence of cerebral WMH on brain magnetic resonance imaging (MRI) from 870 non-stroke outpatient subjects. The subjects were divided into three groups according to the consecutive level of MPV (low T1, middle T2, and high T3 MPV tertile groups). Demographic data and laboratory data for vascular risk factors were evaluated.Results: Univariate analysis disclosed that old age, hypertension, diabetes mellitus, and low renal function were more prevalent in subjects with higher MPV level. In addition, cerebral WMH were more prevalent in subjects with higher MPV level. After adjusting confounding factors, moderate to severe cerebral WMH were signi cantly associated with high MPV tertile level. This association remained signi cant after adjusting for other cerebral vascular pathologies such as large artery atherosclerosis of cerebral arteries, displaying that subjects with middle MPV level (odds ratio (OR): 1.49, 95% con dence interval (95%CI): 1.03-2.15) and those with high MPV level (OR: 1.51, 95%CI: 1.04-2.20) had cerebral WMH lesions more than those with low MPV level. Subjects with more severe cerebral WMH had higher plasma MPV levels than those without (p = 0.02).Conclusions: We found that high MPV level is independently associated with cerebral WMH. This result suggests that platelet activation plays a role in the development of cerebral WMH.

Background: Mean platelet volume (MPV) is regarded as a marker for thrombosis, atherosclerosis, and inflammation in various vascular diseases including stroke. However, it is still unclear whether plasma MPV is associated with cerebral white matter hyperintensities (WMH) and cerebral microvascular pathology in the elderly. Methods: We examined whether MPV level is associated with the presence of cerebral WMH on brain magnetic resonance imaging (MRI) from 870 non-stroke outpatient subjects. The subjects were divided into three groups according to the consecutive level of MPV (low T1, middle T2, and high T3 MPV tertile groups). Demographic data and laboratory data for vascular risk factors were evaluated.Results: Univariate analysis disclosed that old age, hypertension, diabetes mellitus, and low renal function were more prevalent in subjects with higher MPV level. In addition, cerebral WMH were more prevalent in subjects with higher MPV level. After adjusting confounding factors, moderate to severe cerebral WMH were significantly associated with high MPV tertile level. This association remained significant after adjusting for other cerebral vascular pathologies such as large artery atherosclerosis of cerebral arteries, displaying that subjects with middle MPV level (odds ratio (OR): 1.49, 95% confidence interval (95%CI): 1.03-2.15) and those with high MPV level (OR: 1.51, 95%CI: 1.04-2.20) had cerebral WMH lesions more than those with low MPV level. Subjects with more severe cerebral WMH had higher plasma MPV levels than those without (p = 0.02). Conclusions: We found that high MPV level is independently associated with cerebral WMH. This result suggests that platelet activation plays a role in the development of cerebral WMH.

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Background Regarding stent expansion indexes, previous optical coherence tomography (OCT) studies have shown minimal stent area (MSA) to be most predictive of adverse events. Purpose We sought to evaluate the impact of various stent expansion indexes by post-stent OCT on long-term clinical outcomes, and hence to find OCT-defined optimal stent expansion criteria. Methods Of the patients registered in the Yonsei OCT registry, a total of 1071 patients with 1123 native coronary artery lesions treated with new-generation drug-eluting stents under the OCT guidance and analyzable final post-stent OCT were included. Stent expansion indexes and different suboptimal stent expansion criteria were evaluated for their association with device-oriented clinical endpoints (DoCE) including cardiac death, target vessel-related myocardial infarction (TVMI) or stent thrombosis, and target lesion revascularization. Major safety events (MSE) included cardiac death, TVMI or stent thrombosis. Results The median follow-up period was 40.6 (interquartile range 22.0–50.0) months. As a continuous variable, MSA, adaptive volumetric stent expansion (stent volume/adaptive reference lumen volume) and overall volumetric stent expansion (stent volume/post-stent lumen volume) were significantly predictive of DoCE. As a categorical criteria, MSA <5.0 mm2 (hazard ratio [HR] 3.80; 95% confidence interval [CI] 1.53–9.45), MSA/distal reference lumen area <90% (HR 2.13; 95% CI 1.10–4.14), and overall volumetric stent expansion ≥96.6% (HR 2.38; 95% CI 1.09–5.22) were independently associated with DoCE after adjusting for confounders, and a total malapposition volume ≥7.0 mm3 (HR 3.38; 95% CI 1.05–10.93) was linked to MSE. Conclusions This OCT study highlights that sufficient stent expansion to achieve adequate absolute MSA and relative MSA by distal reference lumen area and alleviate significant malapposition is important to improve clinical outcome, but overall stent overexpansion may have deleterious effect. Funding Acknowledgement Type of funding sources: None.