ABSTRACT
BACKGROUND AND PURPOSE: Hemostatic abnormalities have been shown previously in stroke patients. The purpose of this study was to assess the activity of selected parameters of the coagulation system in acute reversible cerebral ischemia. METHODS: We measured fibrinopeptide A, thrombin-antithrombin III, and D-dimer in 36 patients in both the acute (< 7 days) and postacute stage (1 and 3 months) after a transient ischemic attack (TIA). The results were compared with those of 20 asymptomatic patients with a history of remote TIA and 65 age- and sex-matched controls. RESULTS: Mean fibrinopeptide A and thrombin-antithrombin III values were elevated in the acute stage after a TIA (P < .02) compared with levels at 1 month. In contrast, D-dimer was significantly increased at all three times points after the event when compared with remote TIA (P < .05) or control subjects (P < .001). No association could be found between marker levels and clinical outcome or the degree of cervical atherosclerosis as assessed by duplex ultrasonography. CONCLUSIONS: These findings suggest that after acute reversible cerebral ischemia, there is early transient activation of thrombogenesis and ongoing fibrinolysis.
Subject(s)
Antithrombin III/analysis , Fibrinopeptide A/analysis , Ischemic Attack, Transient/blood , Peptide Hydrolases/analysis , Thrombin/analysis , Aged , Aged, 80 and over , Biomarkers/blood , Female , Follow-Up Studies , Humans , Male , Middle Aged , Reference Values , Time FactorsABSTRACT
A patient with a consumptive coagulopathy of 11 months' duration that was due to a large left atrial mural thrombus is described. Bleeding occurred only with the hemostatic challenge of surgery. Heparin was used perioperatively to facilitate two surgical procedures. The coagulopathy was reversed by removal of the thrombus.