Title Antithrombin III associated with fibrinogen predicts the risk of cerebral ischemic stroke
Authors Meng, Ran
Li, Zhi-Yong
Ji, Xunming
Ding, Yuchuan
Meng, Sui
Wang, Xiaoying
Affiliation Beijing Univ, Div Neurol, Shijitan Hosp, Clin Med Coll 9, Beijing 100038, Peoples R China.
Capital Med Univ, Xuanwu Hosp, Beijing 100053, Peoples R China.
Southeast Univ, Sch Biol Sci & Med Engn, Nanjing, Peoples R China.
Univ Cambridge, Cambridge Univ Hosp NHS Fdn Trust, Univ Dept Radiol, Cambridge CB2 0QQ, England.
Univ Int Business & Economics, Beijing 100029, Peoples R China.
Harvard Univ, Sch Med, Neuroprotect Res Lab, Boston, MA 02129 USA.
Keywords Antithrombin III
Fibrinogen
Ischemic stroke
Acute
TISSUE-PLASMINOGEN ACTIVATOR
C-REACTIVE PROTEIN
THERAPY
THROMBOLYSIS
INFARCTION
THROMBOSIS
WINDOW
ATTACK
TIME
Issue Date 2011
Publisher clinical neurology and neurosurgery
Citation CLINICAL NEUROLOGY AND NEUROSURGERY.2011,113,(5),380-386.
Abstract Background and purpose: The purpose of this study is to examine the feasibility of developing plasma predictive value biomarkers of cerebral ischemic stroke before imaging evidence is acquired. Methods: Blood samples were obtained from 198 patients who attended our neurology department as emergencies - with symptoms of vertigo, numbness, limb weakness, etc. - within 4.5 h of symptom onset, and before imaging evidence was obtained and medical treatment. After the final diagnosis was made by MRI/DWI/MRA or CTA in the following 24-72 h, the above cases were divided into two groups: stroke group and non-stroke group according to the imaging results. The levels of baseline plasma antithrombin III (AT-III), thrombin-antithrombin III (TAT), fibrinogen, D-dimer and high-sensitivity C-reactive protein (hsCRP) in the two groups were assayed. Results: The level of the baseline AT-III in the stroke group was 118.07 +/- 26.22%, which was lower than that of the non-stroke group (283.83 +/- 38.39%). The levels of TAT, fibrinogen, hsCRP were 7.24 +/- 2.28 mu g/L, 5.49 +/- 0.98 g/L, and 2.17 +/- 1.07 mg/L, respectively, which were higher than those of the non-stroke group (2.53 +/- 1.23 mu g/L, 3.35 +/- 0.50 g/L, 1.82 +/- 0.67 mg/L). All the P-values were less than 0.001. The D-dimer level was 322.57 +/- 60.3411 mu g/L, which was slightly higher than that of the non-stroke group (305.76 +/- 49.52 mu g/L), but the P-value was 0.667. The sensitivities of AT-III, TAT, fibrinogen, D-dimer and hsCRP for predicting ischemic stroke tendency were 97.37%, 96.05%, 3.29%, 7.89%, but the specificity was 93.62%, 82.61%, 100% and 100%, respectively, and all the P-values were less than 0.001. High levels of D-dimer and hsCRP were mainly seen in the few cases with severe large-vessel infarction. Conclusions: Clinical manifestations of acute focal neurological deficits were associated with plasma AT-III and fibrinogen. These tests might help the risk assessment of acute cerebral ischemic stroke and/or TIA with infarction tendency in the superacute stage before positive imaging evidence is obtained. (C) 2011 Elsevier B.V. All rights reserved.
URI http://hdl.handle.net/20.500.11897/187886
ISSN 0303-8467
DOI 10.1016/j.clineuro.2010.12.016
Indexed SCI(E)
PubMed
Appears in Collections: 北京世纪坛医院

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