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Antithrombin III associated with fibrinogen predicts the risk of cerebral ischemic stroke.
MedLine Citation:
PMID:  21316837     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: The purpose of this study is to examine the feasibility of developing plasma predictive value biomarkers of cerebral ischemic stroke before imaging evidence is acquired. METHODS: Blood samples were obtained from 198 patients who attended our neurology department as emergencies - with symptoms of vertigo, numbness, limb weakness, etc. - within 4.5h of symptom onset, and before imaging evidence was obtained and medical treatment. After the final diagnosis was made by MRI/DWI/MRA or CTA in the following 24-72h, the above cases were divided into two groups: stroke group and non-stroke group according to the imaging results. The levels of baseline plasma antithrombin III (AT-III), thrombin-antithrombin III (TAT), fibrinogen, D-dimer and high-sensitivity C-reactive protein (hsCRP) in the two groups were assayed. RESULTS: The level of the baseline AT-III in the stroke group was 118.07±26.22%, which was lower than that of the non-stroke group (283.83±38.39%). The levels of TAT, fibrinogen, hsCRP were 7.24±2.28μg/L, 5.49±0.98g/L, and 2.17±1.07mg/L, respectively, which were higher than those of the non-stroke group (2.53±1.23μg/L, 3.35±0.50g/L, 1.82±0.67mg/L). All the P-values were less than 0.001. The D-dimer level was 322.57±60.34μg/L, which was slightly higher than that of the non-stroke group (305.76±49.52μg/L), but the P-value was 0.667. The sensitivities of AT-III, TAT, fibrinogen, D-dimer and hsCRP for predicting ischemic stroke tendency were 97.37%, 96.05%, 3.29%, 7.89%, but the specificity was 93.62%, 82.61%, 100% and 100%, respectively, and all the P-values were less than 0.001. High levels of D-dimer and hsCRP were mainly seen in the few cases with severe large-vessel infarction. CONCLUSIONS: Clinical manifestations of acute focal neurological deficits were associated with plasma AT-III and fibrinogen. These tests might help the risk assessment of acute cerebral ischemic stroke and/or TIA with infarction tendency in the superacute stage before positive imaging evidence is obtained.
Authors:
Ran Meng; Zhi-Yong Li; Xunming Ji; Yuchuan Ding; Sui Meng; Xiaoying Wang
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-11
Journal Detail:
Title:  Clinical neurology and neurosurgery     Volume:  -     ISSN:  1872-6968     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7502039     Medline TA:  Clin Neurol Neurosurg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier B.V. All rights reserved.
Affiliation:
Division of Neurology, Shijitan Hospital, The Ninth Clinical Medical College of Beijing University, Beijing 100038, China; Neuroprotection Research Laboratory, Harvard Medical School, Boston, MA 02129, USA.
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