This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Takano, K. Articles by Omae, T. Search for Related Content PubMed PubMed Citation Articles by Takano, K. Articles by Omae, T.

Stroke, Vol 22, 12-16, Copyright © 1991 by American Heart Association

ARTICLES

Activation of coagulation in acute cardioembolic stroke

K Takano, T Yamaguchi, H Kato and T Omae
Department of Medicine, National Cardiovascular Center, Osaka, Japan.

The hematologic disorders in patients with acute cardioembolic stroke are not fully understood, and no reliable measures are available to identify patients at high risk for recurrent embolism. We analyzed coagulation and fibrinolytic functions in 22 patients with cardiogenic cerebral embolism less than or equal to 24 hours after onset and in 25 age-matched controls. The levels of antithrombin III, protein C, and alpha 2-plasmin inhibitor were significantly lower in the patients than in the controls (p less than 0.001, 0.02, and 0.05, respectively). In contrast, the plasma concentrations of thrombin-antithrombin III complex and crosslinked D-dimer were markedly higher in the patients than in the controls (p less than 0.01 and 0.001, respectively). At the time of admission, the plasma concentrations of thrombin-antithrombin III complex and crosslinked D-dimer in the eight patients at high risk for recurrent embolization (one with prodromal embolism, three with intracardiac thrombi, and four with recurrent embolization) were 2.8 and 3.5 times, respectively, higher than those in the 14 patients without recurrence or thrombus formation. The lowest concentration of crosslinked D-dimer in the eight patients at high risk for recurrent embolization was 600 ng/ml on admission. Our results suggest that patients with acute cardioembolic stroke have various degrees of consumption coagulopathy and that the plasma concentrations of thrombin- antithrombin III complex and crosslinked D-dimer can be useful indicators of those who are prone to recurrent embolization during this stage.

This article has been cited by other articles:

				N. Turgut, O. Akdemir, B. Turgut, M. Demir, G. Ekuklu, O. Vural, G. Ozbay, and U. Utku Hypercoagulopathy in Stroke Patients with Nonvalvular Atrial Fibrillation: Hematologic and Cardiologic Investigations Clinical and Applied Thrombosis/Hemostasis, January 1, 2006; 12(1): 15 - 20. [Abstract] [PDF]

				J. Kelly, A. Rudd, R. Lewis, and B. J. Hunt Venous Thromboembolism After Acute Stroke Stroke, January 1, 2001; 32(1): 262 - 267. [Abstract] [Full Text] [PDF]

				H. Tomimoto, I. Akiguchi, H. Wakita, A. Osaki, M. Hayashi, and Y. Yamamoto Coagulation Activation in Patients With Binswanger Disease Arch Neurol, September 1, 1999; 56(9): 1104 - 1108. [Abstract] [Full Text] [PDF]

				W. M. Feinberg, L. P. Erickson, D. Bruck, and J. Kittelson Hemostatic Markers in Acute Ischemic Stroke: Association With Stroke Type, Severity, and Outcome Stroke, August 1, 1996; 27(8): 1296 - 1300. [Abstract] [Full Text]

				T. Nagao, M. Hamamoto, A. Kanda, T. Tsuganesawa, M. Ueda, K. Kobayashi, T. Miyazaki, and A. Terashi Platelet Activation Is Not Involved in Acceleration of the Coagulation System in Acute Cardioembolic Stroke With Nonvalvular Atrial Fibrillation Stroke, August 1, 1995; 26(8): 1365 - 1368. [Abstract] [Full Text]