Document Detail


Fibrin clot properties in acute ischemic stroke: relation to neurological deficit.
MedLine Citation:
PMID:  19942259     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Hypercoagulable state occurs in patients with acute vascular events. We wondered whether clot structure/function is altered in acute ischemic stroke (AIS), like in acute myocardial infarction. PATIENTS AND METHODS: In 45 consecutive patients with AIS (24M, 21F), aged 67.4+/-10.9 years, and 45 healthy controls matched for age and sex, we investigated plasma fibrin clot structure/function by permeation, turbidity, and efficiency of fibrinolysis. RESULTS: Compared to controls, AIS patients produced clots that had 30.5% less porous network (p<0.0001), were less susceptible to fibrinolysis (10.8% longer lysis time, p=0.001), were 20.5% more compact (p<0.0001), had 17.1% higher clot mass (p<0.0001), and showed increased (by 10.2%) overall fiber thickness (p<0.0001) with 8% shorter lag phase of fibrin formation (p=0.0002). Maximum rate of D-dimer release from clots was similar. Multiple regression analyses for all subjects (n=90) showed that being a stroke patient (p<0.0001), fibrinogen (p<0.0001) and lipoprotein(a) (p=0.0075) were independent predictors of clot permeability (model R2 0.79). Only fibrinogen (p<0.0001) and lipoprotein(a) (p=0.0026) predicted lysis time. All other fibrin parameters were predicted only by being a stroke patient. Clot compaction was associated with neurological deficit on admission (r=-0.81; p<0.0001) and at discharge (r=-0.69; p<0.0001). Patients with 0 or 1 point in the modified Rankin scale (n=19) had 13.3% higher clot permeability compared to the remainder (p=0.02). CONCLUSIONS: This study is the first to show that AIS is associated with unfavorably altered fibrin clot properties that might correlate with neurological deficit.
Authors:
Anetta Undas; Agnieszka Slowik; Pawel Wolkow; Andrzej Szczudlik; Wiesława Tracz
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-11-26
Journal Detail:
Title:  Thrombosis research     Volume:  125     ISSN:  1879-2472     ISO Abbreviation:  Thromb. Res.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-26     Completed Date:  2010-07-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0326377     Medline TA:  Thromb Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  357-61     Citation Subset:  IM    
Copyright Information:
(c) 2009 Elsevier Ltd. All rights reserved.
Affiliation:
Institute of Cardiology, Jagiellonian University School of Medicine, Cracow, Poland. mmundas@cyf-kr.edu.pl
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Blood Coagulation Tests
Family
Female
Fibrin / metabolism*
Fibrin Fibrinogen Degradation Products / metabolism
Fibrinogen / genetics
Fibrinolysis / physiology*
Humans
Intracranial Thrombosis
Ischemia
Male
Middle Aged
Permeability
Stroke / blood*
Thrombosis / blood
Chemical
Reg. No./Substance:
0/Fibrin Fibrinogen Degradation Products; 0/fibrin fragment D; 9001-31-4/Fibrin; 9001-32-5/Fibrinogen

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