Tissue Activator of Plasminogen, Inhibitor of Plasmatic Activator-l, and
von Willebrand Factor in Acute and Convalescent Phases of Ischemic
Cerebrovascular Accident
Vlachová I.1, Krčová V.2, Herzig R.1, Slavík L.2, Bártková A.1, Vaverková H.3, Křupka B.1,Šaňák D.1, Urbánek K.1, Budíková M.4, Sovová E.5, Kaňovský P.1
1Neurologická klinika LF UP a FN v Olomouci 2Hemato-onkologická klinika LF UP a FN v Olomouci 3III. Interní klinika LF UP a FN v Olomouci 4Klinika nukleární medicíny LF UP v FN v Olomouci 5I. interní klinika LF UP a FN v Olomouci |
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Summary:
Introduction: The acute phase of ischemic cerebrovascular accident (iCVA) is
accompanied with changes of the fibrinolytic system. The aim of the research was
to evaluate the effects of von Willenbrand factor (vWF), tissue plasminogen activator
(t-PA) and inhibitor of plasmatic activator l (PAI-l) on the severity of ischemic stroke in the acute phase, and to judge their possible predictive value. Patients and methods: The plasma levels
of the factors mentioned above were determined in 109 probands (66 men and 43 women, mean age 61.5 9.9 years)
by 24 hours after the iCVA development. The accident severity was assessed according to NIHSS criteria. A set was
divided into three groups: atherothrombotic, embolic arterio-arterial and cardioembolic strokes. Three months
after the acute phase, the studied factors were investigated in 73 probands (40 men, 33 women). A control set consisted
of 58 healthy subjects (32 men, 26 women), mean age 57.1 9.9 years. Results: Higher values of vWF were
found in the acute phase of iCVA in the studied set if compared with controls (p = 0.0002) and in patients with
NIHSS 10 (p = 0.037). The level of PAI-l was lower in probands in comparison with controls (p = 0.009). Patients
with arterio-arterial embolism showed higher values of t-PA (p = 0.030) if compared with patients with cardiac
embolism. Evaluating the set three months later, it differed from controls by higher level of vWF (p = 0.002), if compared
with the input values, it showed a higher level of PAI-l (p = 0.004) and decreased values of t-PA (p = 0.045).
Conclusion: In the acute phase of the disease, considerable endothelial dysfunction is prevailing in the studied set
together with increased activity of thrombocytes presented by vWF that is also evident in the convalescent phase.
The constellation of changes of PAI-l and t-PA during three months since the accident development with the signs
of high activity of fibrinolytic potential is considered as a marker of increased risk of the stroke relapse.
Key words:
ischemic stroke, von Willebrand factor, tissue activator of plasminogen, inhibitor of plasminogen-l
activator
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