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Blood clots may increase white matter hyperintensities after menopause
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In vivo platelet activation could play a role in events that lead to the development of white matter hyperintensity in recently menopausal women, according to data from the Kronos Early Estrogen Prevention Study, or KEEPS. The research was published in the journal Neurology.
“This study suggests that the tendency of the blood to clot may contribute to a cascade of events leading to the development of brain damage in women who have recently gone through menopause,” study researcher Kejal Kantarci, MD, of the Mayo Clinic in Rochester, Minn., said in a press release. “Preventing the platelets from developing these microvesicles could be a way to stop the progression of white matter hyperintensities (WMH) in the brain.”
Kejal Kantarci
To understand the link between conventional cardiovascular risk factors, markers of platelet activation and thrombogenic bloodborne microvesicles with WMH load and progression in recently menopausal women, Kantarci and colleagues examined data from women (n=95) enrolled in KEEPS. Participants had undergone MRI at baseline and at 18, 36 and 48 months after a random assignment to one of the following: oral conjugated equine estrogen (0.45 mg per day; Premarin, Wyeth Pharmaceuticals); 17-beta estradiol transdermal skin patch (50 mcg daily; Climara, Bayer HealthCare); or placebo pill and patch.
According to data, conventional CV risk factors, carotid intima-medial thickness, coronary arterial calcification, plasma lipids, markers of platelet activation and thrombogenic microvesicles were measured at baseline. Researchers wrote that WMH were observed in all women, and WMH to white matter volume fraction at baseline was 0.88% (95% CI, 0.69-1.16). At 36 months, WMH volume increased by 122.1 mm3 (95% CI, –164.3 to 539.5), and by 155.4 mm3 (95% CI, –92.13 to 599.4) at 48 months.
Based on these findings, the researchers wrote that these notable increases were related to platelet-derived and total thrombogenic microvesicles at baseline (P=.03).
“The findings of the present study indicate that activated platelets are associated with WMH load and progression in recently menopausal women, and thus, modifying activation state of platelets may serve as a therapeutic target to prevent progression of WMH in the brain,” the researchers wrote.
They conclude that further research is needed to examine the underlying mechanisms of the development of WMH and its progression among recently menopausal women.
Disclosure: Kantarci reported financial ties with Takeda. See the study for a full list of disclosures.
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