Thrombin Generation in Acute Ischaemic Stroke
Introduction. Stroke remains a global leading cause of death and disability. Traditional description of plasma biology in the aftermath of acute ischaemic stroke favours development of hypercoagulability, resulting from complex interplay between plasma and endothelial factors. However, no single ass...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Stroke Research and Treatment |
| Online Access: | http://dx.doi.org/10.1155/2016/7940680 |
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| author | Ibrahim O. Balogun Lara N. Roberts Raj Patel Rohan Pathansali Lalit Kalra Roopen Arya |
| author_facet | Ibrahim O. Balogun Lara N. Roberts Raj Patel Rohan Pathansali Lalit Kalra Roopen Arya |
| author_sort | Ibrahim O. Balogun |
| collection | DOAJ |
| description | Introduction. Stroke remains a global leading cause of death and disability. Traditional description of plasma biology in the aftermath of acute ischaemic stroke favours development of hypercoagulability, resulting from complex interplay between plasma and endothelial factors. However, no single assay measures the overall global coagulation process. We postulate that thrombin generation would assist in identifying coagulation abnormalities after acute stroke. Aim. To investigate the coagulation abnormalities after acute ischaemic stroke using thrombin generation. Methods. We evaluated thrombin generation, measured with calibrated automated thrombography in stroke of different aetiological types (n=170) within 48 hours of symptoms onset (baseline) and in the second week (time 2) and in normal healthy volunteers (n=71). Results. Two-point thrombin generation assays showed prolonged lag time and time to peak at baseline (3.3 (2.9, 4.0) versus 3.6 (3.2, 4.7); p=0.005) and (3.3 (2.9, 4.0) versus 3.6 (3.2, 4.7); p=0.002), respectively, and at time 2 (3.5 (2.9, 4.2) versus 4.0 (3.1, 4.9); p=0.004) and (5.9 (5.3, 6.6) versus 6.8 (5.8, 7.7) p=0.05), respectively, in cardioembolic stroke (n=39), when compared to noncardioembolic stroke (n=117). The result was reproduced in multiple comparisons between acute ischaemic stroke subgroups and normal healthy volunteers. Endogenous thrombin potential and peak thrombin did not indicate hypercoagulability after acute ischaemic stroke, and thrombolytic therapy did not affect thrombin generation assays. Conclusion. Our findings suggest that thrombin generation in platelet poor plasma is not useful in defining hypercoagulability in acute ischaemic stroke. This is similar to observed trend in coronary artery disease and contrary to other hypercoagulable states. |
| format | Article |
| id | doaj-art-ae31a9c93ca84ac193801345906bae51 |
| institution | Kabale University |
| issn | 2090-8105 2042-0056 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Stroke Research and Treatment |
| spelling | doaj-art-ae31a9c93ca84ac193801345906bae512025-02-03T05:52:40ZengWileyStroke Research and Treatment2090-81052042-00562016-01-01201610.1155/2016/79406807940680Thrombin Generation in Acute Ischaemic StrokeIbrahim O. Balogun0Lara N. Roberts1Raj Patel2Rohan Pathansali3Lalit Kalra4Roopen Arya5King’s Thrombosis Centre, Department of Haematological Medicine, King’s College Hospital NHS Foundation Trust, London, UKKing’s Thrombosis Centre, Department of Haematological Medicine, King’s College Hospital NHS Foundation Trust, London, UKKing’s Thrombosis Centre, Department of Haematological Medicine, King’s College Hospital NHS Foundation Trust, London, UKDepartment of Stroke Medicine, King’s College Hospital NHS Foundation Trust, London, UKClinical Neuroscience Department, Academic Neuroscience Centre, King’s College London, London, UKKing’s Thrombosis Centre, Department of Haematological Medicine, King’s College Hospital NHS Foundation Trust, London, UKIntroduction. Stroke remains a global leading cause of death and disability. Traditional description of plasma biology in the aftermath of acute ischaemic stroke favours development of hypercoagulability, resulting from complex interplay between plasma and endothelial factors. However, no single assay measures the overall global coagulation process. We postulate that thrombin generation would assist in identifying coagulation abnormalities after acute stroke. Aim. To investigate the coagulation abnormalities after acute ischaemic stroke using thrombin generation. Methods. We evaluated thrombin generation, measured with calibrated automated thrombography in stroke of different aetiological types (n=170) within 48 hours of symptoms onset (baseline) and in the second week (time 2) and in normal healthy volunteers (n=71). Results. Two-point thrombin generation assays showed prolonged lag time and time to peak at baseline (3.3 (2.9, 4.0) versus 3.6 (3.2, 4.7); p=0.005) and (3.3 (2.9, 4.0) versus 3.6 (3.2, 4.7); p=0.002), respectively, and at time 2 (3.5 (2.9, 4.2) versus 4.0 (3.1, 4.9); p=0.004) and (5.9 (5.3, 6.6) versus 6.8 (5.8, 7.7) p=0.05), respectively, in cardioembolic stroke (n=39), when compared to noncardioembolic stroke (n=117). The result was reproduced in multiple comparisons between acute ischaemic stroke subgroups and normal healthy volunteers. Endogenous thrombin potential and peak thrombin did not indicate hypercoagulability after acute ischaemic stroke, and thrombolytic therapy did not affect thrombin generation assays. Conclusion. Our findings suggest that thrombin generation in platelet poor plasma is not useful in defining hypercoagulability in acute ischaemic stroke. This is similar to observed trend in coronary artery disease and contrary to other hypercoagulable states.http://dx.doi.org/10.1155/2016/7940680 |
| spellingShingle | Ibrahim O. Balogun Lara N. Roberts Raj Patel Rohan Pathansali Lalit Kalra Roopen Arya Thrombin Generation in Acute Ischaemic Stroke Stroke Research and Treatment |
| title | Thrombin Generation in Acute Ischaemic Stroke |
| title_full | Thrombin Generation in Acute Ischaemic Stroke |
| title_fullStr | Thrombin Generation in Acute Ischaemic Stroke |
| title_full_unstemmed | Thrombin Generation in Acute Ischaemic Stroke |
| title_short | Thrombin Generation in Acute Ischaemic Stroke |
| title_sort | thrombin generation in acute ischaemic stroke |
| url | http://dx.doi.org/10.1155/2016/7940680 |
| work_keys_str_mv | AT ibrahimobalogun thrombingenerationinacuteischaemicstroke AT laranroberts thrombingenerationinacuteischaemicstroke AT rajpatel thrombingenerationinacuteischaemicstroke AT rohanpathansali thrombingenerationinacuteischaemicstroke AT lalitkalra thrombingenerationinacuteischaemicstroke AT roopenarya thrombingenerationinacuteischaemicstroke |