Background: Hemorrhagic transformation (HT) is a frequent complication of acute
ischemic stroke (AIS). Mean platelet volume (MPV) is a marker of platelet function. The relationship
between MPV and HT remains unclear.
Methods: From January 1st, 2012 to December 31st 2016, we consecutively enrolled AIS patients
admitted to the Department of Neurology of West China Hospital. MPV was measured on admission.
HT was diagnosed by brain imaging and classified into hemorrhagic infarct (HI) and parenchymal
hematoma (PH). Moreover, subjects were divided into tertiles according to MPV levels.
Confounders were identified by univariate analysis and multivariate logistic regression was performed
to explore the association between MPV and HT as well as HT subtypes. Also, a generalized
additive model was used to investigate whether a non-linear association existed between MPV and
Results: A total of 783 AIS patients were included. 63 patients (8.0%) developed HT: 34 (4.3%)
HI and 29 (3.7%) PH. It was observed that MPV positively correlated with HT. After adjustment
for confounders, patients in the highest MPV tertile had a significantly increased risk of HT compared
to patients in the lowest tertile (odds ratio 2.3, 95% confidence interval 1.0-5.4, P=0.04).
The risk of HT increased step-wise across MPV tertiles (P for trend=0.04). MPV tertiles significantly
correlated with HI rather than PH. The generalized additive model demonstrated a nonlinear
association between MPV and HT (P=0.02).
Conclusion: The risk of HT increased with increasing MPV level in a dose-dependent manner.
Patients with elevated MPV levels were more likely to develop HI rather than PH.