Antithrombin III associated with fibrinogen predicts the risk of cerebral ischemic stroke.

Abstract

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 4.5 h 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 24-72 h, 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±2.28 μg/L, 5.49±0.98 g/L, and 2.17±1.07 mg/L, respectively, which were higher than those of the non-stroke group (2.53±1.23 μg/L, 3.35±0.50 g/L, 1.82±0.67 mg/L). All the P-values were less than 0.001. The D-dimer level was 322.57±60.34 μg/L, which was slightly higher than that of the non-stroke group (305.76±49.52 μg/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
• Journal: Clinical neurology and neurosurgery (Clin Neurol Neurosurg) Vol. 113 Issue 5 Pg. 380-6 (Jun 2011) ISSN: 1872-6968 [Electronic] Netherlands
• PMID: 21316837 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2011 Elsevier B.V. All rights reserved.

Chemical References

• Biomarkers
• Fibrin Fibrinogen Degradation Products
• Fibrinolytic Agents
• fibrin fragment D
• Antithrombin III
• Fibrinogen
• C-Reactive Protein
• Thrombin
• Tissue Plasminogen Activator

Topics

• Adult
• Aged
• Antithrombin III (analysis)
• Biomarkers (blood)
• Brain Ischemia (blood, complications, economics)
• C-Reactive Protein (analysis)
• Costs and Cost Analysis
• Diabetes Mellitus (blood)
• Female
• Fibrin Fibrinogen Degradation Products (analysis)
• Fibrinogen (analysis)
• Fibrinolytic Agents (therapeutic use)
• Humans
• Hyperlipidemias (blood)
• Male
• Middle Aged
• Predictive Value of Tests
• Risk Factors
• Stroke (blood, economics, etiology)
• Thrombin (analysis)
• Tissue Plasminogen Activator (therapeutic use)