Admission fibrinolytic profile is associated with symptomatic hemorrhagic transformation in stroke patients treated with tissue plasminogen activator

Stroke; a Journal of Cerebral Circulation
Marc RibóJ Alvarez-Sabín

Abstract

Symptomatic intracranial hemorrhage (SICH) is the most feared complication after tissue plasminogen activator (tPA) stroke treatment. Endogenous fibrinolysis inhibitors play an essential role in the coagulation/fibrinolysis balance and may be involved in the bleeding process. We aim to determine the predictive value of pretreatment levels of fibrinolysis inhibitors (PAI-1, lipoprotein(a), TAFI, and homocysteine) on SICH. Consecutive tPA-treated stroke patients with middle cerebral artery occlusion were studied. Baseline blood samples were obtained just before tPA administration and fibrinolysis inhibitors were determined. A second computed tomography (CT) scan was obtained at 24 hours or when a neurological worsening occurred to rule out SICH. Seventy-seven patients (40% women, age 75 years) were studied. Median admission National Institutes of Health Stroke Scale was 17 (range, 7 to 22) and mean time to treatment was 160 minutes. Six patients (7.9%) presented with a SICH. In analyses based on clinical and CT variables, no relation could be found with SICH. When laboratory data were analyzed, patients who experienced SICH showed lower baseline PAI-1 (21.7+/-3.5 ng/mL versus 31.8+/-12.1 ng/mL; P<0.01) and higher TAFI (216.7+/-78...Continue Reading

References

Dec 14, 1995·The New England Journal of Medicine·UNKNOWN National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group
Jun 16, 1995·The Journal of Biological Chemistry·L BajzarM E Nesheim
Nov 18, 1998·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Z NagyR Machovich
Aug 15, 2001·Neurology·A M DemchukUNKNOWN mMulticentre tPA Stroke Survey Group
Mar 22, 2003·Stroke; a Journal of Cerebral Circulation·Joan MontanerJosé Alvarez-Sabín
Mar 29, 2003·Stroke; a Journal of Cerebral Circulation·Peter U HeuschmannUNKNOWN Competence Net Stroke
Oct 3, 2003·Journal of Thrombosis and Haemostasis : JTH·I Juhan-VagueUNKNOWN PRIME Study Group
Nov 8, 2003·Stroke; a Journal of Cerebral Circulation·Andrew KayJames Nicoll

❮ Previous
Next ❯

Citations

Nov 9, 2007·Journal of Neurology·I Korn-LubetzkiB Steiner-Birmanns
Feb 4, 2010·Journal of Neurology·Daniel SanákPetr Kanovský
Jan 18, 2013·Current Treatment Options in Neurology·Raphaella E Weiser, Kevin N Sheth
Dec 6, 2012·Neurocritical Care·Kiersten E NorbyAdnan I Qureshi
Jun 15, 2011·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Glen C Jickling, Frank R Sharp
Jun 4, 2013·Lancet Neurology·José Álvarez-SabínCarlos S Kase
Nov 29, 2007·Cerebrovascular Diseases·Mar Castellanos, Joaquín Serena
Aug 11, 2012·Stroke; a Journal of Cerebral Circulation·Anna Tjärnlund-WolfXiaoying Wang
Oct 11, 2012·International Journal of General Medicine·Josef Yayan
May 30, 2009·Vascular Health and Risk Management·Giuseppe MicieliPiera Angela Tosi
Feb 18, 2010·Biomarkers in Medicine·Matthew B Maas, Karen L Furie
Feb 8, 2013·Biomarkers in Medicine·Lena Rothstein, Glen C Jickling
Jun 16, 2007·Stroke; a Journal of Cerebral Circulation·Maarten G LansbergUNKNOWN DEFUSE Investigators
Feb 11, 2011·Expert Review of Neurotherapeutics·Mira Katan, Mitchell S V Elkind
Feb 8, 2016·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Yi-Ping You
Apr 13, 2010·Neurobiology of Aging·Sophie Domingues-MontanariUNKNOWN Stroke Project Cerebrovascular Diseases Study Group, Spanish Society of Neurology
Jun 29, 2006·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Sharyl R Martini, Thomas A Kent
Jan 6, 2006·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Yang TangFrank R Sharp
Nov 28, 2013·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Glen C JicklingFrank R Sharp
Jun 3, 2008·Neurologic Clinics·Anna Finley Caulfield, Christine A C Wijman
Aug 11, 2007·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Sarra SaidiWassim Y Almawi
Jan 24, 2007·Critical Care Clinics·Anna Finley Caulfield, Christine A C Wijman
Sep 22, 2009·International Journal of Stroke : Official Journal of the International Stroke Society·D DowlatshahiUNKNOWN Investigators of the Registry of the Canadian Stroke Network
Oct 20, 2007·Journal of Thrombosis and Haemostasis : JTH·J L WillemseD F Hendriks
Mar 19, 2016·Revue neurologique·I MaestriniR Bordet
Mar 9, 2013·Journal of Thrombosis and Haemostasis : JTH·J B Echouffo-TcheuguiA P Kengne
Sep 1, 2011·Mass Spectrometry Reviews·Peihong ZhuJohn G Marshall
Mar 28, 2012·Annals of Neurology·Dawn N Kernagis, Daniel T Laskowitz
Dec 17, 2014·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Laura VandelliAndrea Zini

❮ Previous
Next ❯

Related Concepts

Related Feeds

ApoE, Lipids & Cholesterol

Serum cholesterol, triglycerides, apolipoprotein B (APOB)-containing lipoproteins (very low-density lipoprotein (VLDL), immediate-density lipoprotein (IDL), and low-density lipoprotein (LDL), lipoprotein A (LPA)) and the total cholesterol/high-density lipoprotein (HDL) cholesterol ratio are all connected in diseases. Here is the latest research.

Blood Clotting Disorders

Thrombophilia includes conditions with increased tendency for excessive blood clotting. Blood clotting occurs when the body has insufficient amounts of specialized proteins that make blood clot and stop bleeding. Here is the latest research on blood clotting disorders.