The Diagnostic and Prognostic Value of Reticulated Platelets in Ischemic Stroke: Is Immature Platelet Fraction a New Biomarker?

Background and Objectives: Ongoing efforts to develop early diagnostic tools for Acute Ischemic Stroke (AIS) point out the advantages of accessible biomarkers such as Immature Platelet Fraction (IPF). This is particularly important for emergency department (EDs), especially those that are overcrowded and have limited resources. The present study aimed to evaluate the diagnostic, prognostic, and therapeutic significance of IPF in patients with AIS presenting to the ED. Materials and Methods: This prospective case-control study was conducted in an ED. Participants aged 18-years and older who presented with complaints of numbness, weakness, diplopia or visual disturbances, speech or comprehension impairment, confusion, imbalance, impaired coordination and gait, or dizziness were included in the study. The diagnostic value of IPF in AIS and its relationship with short-term prognosis (STP) were investigated. Additional variables potentially associated with parameters such as infarct localization, number of lesions, affected hemisphere, main artery status, carotid status and treatment method were also analyzed. Results: The median age of the study participants was 67 years (Q1 = 54, Q3 = 76), with 48.9% (n = 88) being female and 51.1% (n = 92) male. Receiver operating characteristic curve analysis demonstrated that IPF was statistically significantly superior to other complete blood count parameters in the diagnostic evaluation of AIS. The diagnostic cutoff value of IPF for AIS was calculated as 2.45. An increase of 1 unit in IPF was found to raise the likelihood of AIS by 2.599 times. The Ratio of Red Cell Distribution Width (RDW) to IPF and NEU to IPF, mean corpuscular volume, and infarct volume were found to be significant predictors in STP assessment. Conclusions: Although not definitive alone, IPF may aid early stroke recognition, support treatment monitoring, and inform targeted therapies. The use of IPF, a biomarker that can be rapidly obtained, in the diagnosis of AIS is expected to yield beneficial outcomes in patient management, particularly in emergency departments and other clinical settings.