Thrombin generation in acute cardioembolic and non-cardioembolic ischemic stroke.

Increased thrombin generation, as measured by the Calibrated Automated Thrombogram (CAT), has recently been reported to predict ischemic stroke, especially stroke with a cardioembolic source. However, there are few studies on thrombin generation using CAT in patients with manifest ischemic stroke, particularly in patients with cardioembolic stroke not yet on anticoagulation.
Therefore, a prospective cohort study of 205 stroke patients > 45 years of age was performed. They were recruited during their hospital stay or shortly thereafter. Inclusion criteria were ischemic stroke or TIA within two weeks and no atrial fibrillation (AF) in the history or at inclusion. Patients received a thumb ECG device in order to detect silent AF. Blood samples were collected at inclusion and after 1 month. Thrombin generation in plasma after addition of tissue factor was assessed in patients and in healthy controls.
Mean age of patients was 72 ± 7 years and 43% were females. Peak thrombin concentrations were variable among stroke patients but overall significantly higher at both time points (p < 0.0001) compared to controls, and tended to be highest in patients in whom paroxysmal atrial fibrillation was subsequently documented.
Thrombin generation in patients with acute cardioembolic and non-cardioembolic schemic stroke/TIA is variable but overall higher compared to healthy subjects. The long-term prognostic value of thrombin generation in patients with a recent ischemic stroke deserves further investigation.
AuthorsElisabeth Rooth, Piotr Sobocinski-Doliwa, Jovan Antovic, Veronika Frykman Kull, Magnus Von Arbin, Mårten Rosenqvist, Håkan Wallén
JournalScandinavian journal of clinical and laboratory investigation (Scand J Clin Lab Invest) Vol. 73 Issue 7 Pg. 576-84 (Oct 2013) ISSN: 1502-7686 [Electronic] England
PMID24063505 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • C-Reactive Protein
  • Thrombin
  • Aged
  • Aged, 80 and over
  • Atrial Fibrillation (blood)
  • Brain Ischemia (blood)
  • C-Reactive Protein (metabolism)
  • Case-Control Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Thrombin (metabolism)

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