| Autor: |
Putzer AS; Department of Neurology, Hannover Medical School, 30625, Hannover, Germany., Worthmann H; Department of Neurology, Hannover Medical School, 30625, Hannover, Germany., Grosse GM; Department of Neurology, Hannover Medical School, 30625, Hannover, Germany., Goetz F; Institute of Diagnostic and Interventional Neuroradiology, Hannover Medical School, 30625, Hannover, Germany., Martens-Lobenhoffer J; Department of Clinical Pharmacology, Otto-Guericke-University of Magdeburg, University Hospital, 39106, Magdeburg, Germany., Dirks M; Department of Neurology, Hannover Medical School, 30625, Hannover, Germany., Kielstein JT; Medical Clinic V, Academic Teaching Hospital Braunschweig, 38118, Brunswick, Germany., Lichtinghagen R; Department of Clinical Chemistry, Hannover Medical School, 30625, Hannover, Germany., Budde U; Medilys Laboratory, Asklepios Klinik Altona, 22763, Hamburg, Germany., Bode-Böger SM; Department of Clinical Pharmacology, Otto-Guericke-University of Magdeburg, University Hospital, 39106, Magdeburg, Germany., Weissenborn K; Department of Neurology, Hannover Medical School, 30625, Hannover, Germany., Schuppner R; Department of Neurology, Hannover Medical School, 30625, Hannover, Germany. schuppner.ramona@mh-hannover.de. |
| Abstrakt: |
Although intravenous thrombolysis (IVT) with recombinant tissue-plasminogen-activator represents a highly effective treatment in acute ischemic stroke patients, not every patient benefits. We hypothesized that pretreatment levels of mediators of hemostasis (VWF and ADAMTS13) and dimethylarginines (ADMA and SDMA) are associated with early neurological improvement and outcome after IVT in ischemic stroke. Moreover we aimed to investigate the link between ADAMTS13 and markers of inflammation (CRP, IL-6, MMP-9 and MCP-1). In 43 patients with acute ischemic stroke treated with IVT blood samples for determination of the different markers were strictly taken before treatment, as well as at 24 h, 3, 7 and 90 days after symptom onset. Early neurological improvement was assessed using the shift between National Institutes of Health Stroke Scale (NIHSS) at baseline and at 24 h. Outcome at 90 days was assessed using the modified Rankin Scale. The lowest quartile of ADAMTS13 activity was independently associated with less improvement in NIHSS (baseline-24 h) (OR 1.298, p = 0.050). No independent association of ADMA or SDMA levels at baseline with outcome could be shown. Furthermore, IL-6, MCP-1 and CRP levels at 90 days significantly differed between patients with low and high ADAMTS13 activity. Thus, ADAMTS13 might indicate or even influence efficacy of IVT. |
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