# Stroke and Coated-Platelets - A Translational Research Initiative

> **NIH VA I01** · OKLAHOMA CITY VA MEDICAL CENTER · 2021 · —

## Abstract

Stroke is recognized as a major cause of disability and death in elderly veterans. Stroke also
represents a critical, and potentially preventable, risk factor for cognitive decline mostly in the form of
vascular cognitive impairment in veterans. Silent brain infarctions (SBIs) are a manifestation of covert
cerebrovascular disease, without obvious clinical deficit but linked to a significant increase in risk for
subsequent stroke and cognitive decline. Identifying early markers of stroke risk in all veterans is
crucial for developing novel prevention and effective treatment strategies. While SBIs are strongly
linked to increased rates for both stroke and cognitive decline, no biomarker is currently available that
can predict the recurrence or location of these subclinical lesions. Lack of such knowledge limits our
ability to prevent ischemic strokes and vascular cognitive impairment in the aging veteran population.
 Coated-platelets, a subset of procoagulant platelets observed after co-activation with collagen
and thrombin, are significantly increased in patients with ischemic stroke or transient ischemic attack
(TIA) compared to unaffected controls. Higher coated-platelet levels, measured after the initial infarct
correlate with an increased risk for recurrent stroke and with lower cognitive performance post-stroke.
Among medications used to prevent stroke recurrence, we identified clopidogrel as a pharmacological
agent resulting in a sustained decrease in coated-platelet levels. In preliminary studies, we have
shown that higher coated-platelet levels in patients with stroke and TIA are strongly associated with
both the presence and number of SBIs. Additionally, we have found that differential expression of
platelet micro-RNA (miRNA) species may be linked to coated-platelet production, thereby providing
potential for deciphering mechanisms underlying differences in platelet reactivity through modulation
of gene expression. These novel findings raise the possibility that coated-platelets will serve as a risk
stratification tool for SBIs and are part of mechanisms involving platelet procoagulant potential and
platelet miRNA expression that explain the occurrence of SBIs. The research questions for the
current grant are: 1) Are coated-platelet levels markers for increased incidence of SBIs in patients
with stroke/TIA? and 2) Does clopidogrel treatment decrease the incidence of SBIs?
 The objective of the current application is to determine the role of coated-platelets as a marker
for SBIs and as a treatment target to decrease incident SBI. Three specific aims will test these
hypotheses: 1) Determine the relationship between coated-platelets levels and incident silent brain
infarction in veterans with stroke/TIA, and 2) Evaluate the efficacy of clopidogrel on the incidence of
silent brain infarction in veterans with stroke/TIA using a randomized, double-blind aspirin-controlled
clinical trial. We plan to test our hypotheses in a large group of patien...

## Key facts

- **NIH application ID:** 10119701
- **Project number:** 2I01CX000340-10A1
- **Recipient organization:** OKLAHOMA CITY VA MEDICAL CENTER
- **Principal Investigator:** Calin Ioan Prodan
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 2
- **Project period:** 2011-04-01 → 2025-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10119701

## Citation

> US National Institutes of Health, RePORTER application 10119701, Stroke and Coated-Platelets - A Translational Research Initiative (2I01CX000340-10A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10119701. Licensed CC0.

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