J Clin Neurol.  2005 Oct;1(2):142-147. 10.3988/jcn.2005.1.2.142.

Plasma Fibrinolysis Inhibitor Levels in Acute Stroke Patients with Thrombolysis Failure

• Kim SH
• Han SW
• Kim EH
• Kim DJ
• Lee KY
• Kim DI
• Heo JH

• KMID: 1808484
• DOI: http://doi.org/10.3988/jcn.2005.1.2.142

Abstract

BACKGROUND AND PURPOSE
Thrombolytics-induced recanalization fails in a significant portion of patients with ischemic stroke, which is partly due to the resistance of clots to lysis by thrombolytic agents. The pretreatment level of endogenous fibrinolysis inhibitors may affect such thrombolysis failure.
METHODS
We studied 43 stroke patients whose arterial recanalization had been evaluated by angiography, and whose blood had been obtained prior to the administration of thrombolytic agents. Plasma samples from 34 healthy volunteers were used as normal controls. Plasminogen activator inhibitor type 1 (PAI-1) and thrombin-activatable fibrinolysis inhibitor (TAFI) levels were quantified using an enzyme-linked immunosorbent assay.
RESULTS
Arteries were recanalized [Thrombolysis in Myocardial Infarction (TIMI) grade 2 or 3] in 30 patients, but not (TIMI grade 0 or 1) in the other 13. The plasma PAI-1 level was significantly higher in patients without recanalization (nonrecanalization) than in those with recanalization and in normal controls. The TAFI levels did not differ among the groups.
CONCLUSIONS
The pretreatment PAI-1 levels are increased in acute stroke patients with thrombolysis failure.

Keyword

Fibrinolytic agents; Acute stroke; Plasminogen activator inhibitor type 1; Thrombin-activatable fibrinolysis inhibitor

MeSH Terms

Angiography
Arteries
Carboxypeptidase U
Enzyme-Linked Immunosorbent Assay
Fibrinolysis*
Fibrinolytic Agents
Healthy Volunteers
Humans
Myocardial Infarction
Plasma*
Plasminogen Activator Inhibitor 1
Plasminogen Activators
Stroke*
Carboxypeptidase U
Fibrinolytic Agents
Plasminogen Activator Inhibitor 1
Plasminogen Activators

Figure

• 

  Figure 1 Plasma plasminogen activator inhibitor type 1 (PAI-1) (A) and thrombin-activatable fibrinolysis inhibitor (TAFI) (B) levels in each group as measured by an enzyme-linked immunosorbent assay. The PAI-1 level was significantly higher in the nonrecanalization group (N-Rec) than in the normal control (NC) and recanalization (Rec) groups. Medians and interquartile ranges are shown.

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