We studied the effect of antiplatelet
therapy not only on the
secondary prevention of
stroke but also on the suppression of vascular damages in patients with
cerebral thrombosis at the chronic phase. We measured
von Willebrand factor (vWF) as a marker for the endothelial system, and coagulation and fibrinolytic parameters in addition to platelet functions. The platelet aggregation and markers for platelet activation were monitored for the adequate inhibition of platelets. Twenty-one patients were treated with 200 mg
ticlopidine. 9 patients with 100 mg
ticlopidine and 60-150 mg
acetylsalicylic acid, and 18 patients with 200 mg
cilostazol daily. The mean duration of follow up was 8.4 +/- 3.0 months. A patient was attacked by a recurrent
stroke, but no fatal vascular events occurred during the period. A significant decrease was observed in the
collagen- and
ADP-induced platelet aggregation and markers for platelet activation such as
platelet factor 4 (PF4) and
beta-thromboglobulin (beta TG) by the antiplatelet
therapy. In addition, the activities of
coagulation factor VIII (FVIII) and vWF, markers for vascular damages, showed a significant decrease. The results suggest that the antiplatelet
therapy could ameliorate the vascular damage through the inhibition of platelet function. Moreover,
thrombin-antithrombin III complex (TAT) and
alpha 2-plasmin inhibitor-plasmin complex (PIC), markers for the activation of coagulation and fibrinolytic systems, decreased significantly, suggesting that the treatment inhibits the activation of coagulation and fibrinolytic systems induced by the platelet activation. The activities of FVIII and vWF decreased significantly when the level of beta TG or that of PF4 lowered sufficiently by the treatment.(ABSTRACT TRUNCATED AT 250 WORDS)