Hemostatic Markers in Patients at Risk of Cerebral Ischemia
| Autor: | Robert Côté, Christina Wolfson, Susan Solymoss, Ariane Mackey, Jacques R Leclerc, Denis Simard, Fabrice Rouah, France Bourque, Barbara Léger |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Male
medicine.medical_specialty Antithrombin III Myocardial Infarction Ischemia Enzyme-Linked Immunosorbent Assay Asymptomatic Central nervous system disease Risk Factors Internal medicine Plasminogen Activator Inhibitor 1 medicine Humans Carotid Stenosis Fibrinolysin Prospective Studies Myocardial infarction Risk factor Prospective cohort study Stroke Aged Fibrinopeptide A Proportional Hazards Models Advanced and Specialized Nursing Hemostasis alpha-2-Antiplasmin Vascular disease business.industry Incidence Quebec Middle Aged Prognosis medicine.disease Antifibrinolytic Agents Peptide Fragments Surgery Survival Rate Ischemic Attack Transient Cardiology Female Prothrombin Neurology (clinical) medicine.symptom Cardiology and Cardiovascular Medicine business Biomarkers Peptide Hydrolases |
| Zdroj: | Stroke. 31:1856-1862 |
| ISSN: | 1524-4628 0039-2499 |
| DOI: | 10.1161/01.str.31.8.1856 |
| Popis: | Background —Increased levels of markers of hemostasis may assist in the determination of the extent of carotid occlusive disease and the identification of neurologically intact individuals at increased risk of ischemic events. Methods —We conducted a prospective study of 304 subjects, including 82 with a recent (≤7 days) transient ischemic attack (TIA), 157 asymptomatic individuals with a cervical bruit, and 65 control subjects. Baseline evaluation included a neurological assessment, ECG, cervical ultrasonography, and cerebral CT and/or MRI. Levels of markers of coagulation and fibrinolytic activity were also determined. Results were analyzed in relation to the degree of carotid disease and the subsequent occurrence of cerebral and cardiac ischemic events. Results —Over a mean follow-up period of 2.8 years (SD, 1.3 years), 114 ischemic events occurred. Survival analyses showed that prothrombin fragment 1.2 (F 1.2 ) was a predictor of time to cerebral and cardiac ischemic events in the combined TIA and asymptomatic bruit group (relative risk [RR], 1.46; 95% CI, 1.18 to 1.81) as well as in the asymptomatic bruit group separately (RR, 1.70; 95% CI, 1.14 to 2.53). In the TIA group, both F 1.2 (RR, 2.36; 95% CI, 1.19 to 4.68) and severe (≥80%) carotid stenosis (RR, 3.53; 95% CI, 1.19 to 10.51) were predictive of time to ischemic stroke, myocardial infarction, or vascular death. Conclusions —In patients with TIAs and in asymptomatic individuals with cervical bruits, F 1.2 levels were found to be independent predictors of subsequent cerebral and cardiac ischemic events. Our results are consistent with an active role of the coagulation system through upregulation of thrombin in carotid disease progression and in the pathogenesis of ischemic events in patients at risk. |
| Databáze: | OpenAIRE |
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