title: Tissue plasminogen activator and plasminogen activator inhibitor in patients with acute ischemic stroke: relation to stroke etiology.
abstract: Recent studies suggest that high plasma levels of tissue-type plasminogen activator (tPA) and its inhibitor (plasminogen activator inhibitor-1, PAI-1) are markers of an increased risk of atherothrombotic ischemic events such as stroke and myocardial infarction. In this prospective study, we measured tPA antigen, PAI-1 antigen and activity, as well as tPA/PAI-1 complex in patients with acute stroke. Stroke subtypes were classified according to the TOAST criteria. From 132 consecutively screened patients, 89 (100%) were enrolled in this study, including 42 patients (47%) with large artery atherosclerosis (LAA), 32 (36%) with small vessel occlusion (SVO), and 15 (17%) with cardioembolism (CE). Nineteen age-matched neurologic patients without manifestations of cerebrovascular disease served as control subjects (CS). Patients with acute stroke had significantly higher plasma levels of tPA antigen (p < 0.001), PAI-1 antigen (p < 0.05) and PAI activity (p < 0.05) than patients in the control group. t-PA antigen, PAI activity and tPA/PAI-1 complex levels were similar regardless of stroke etiology. Only PAI-1 antigen was lower in patients with cardioembolic stroke than in stroke patients with LAA (p < 0.05). Plasma tPA antigen, PAI-1 antigen, and PAI activity are significantly increased in patients with acute ischemic stroke. Except for PAI-1 antigen, this increase appears not to be related to the underlying stroke etiology.
authors.affiliation: Department of Neurology, Kiel University Hospital, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Zunker
authors.forename: A
authors.initials: A
authors.lastname: Schick
authors.forename: T
authors.initials: T
authors.lastname: Padró
authors.forename: J
authors.initials: J
authors.lastname: Kienast
authors.forename: A
authors.initials: A
authors.lastname: Phillips
authors.forename: E B
authors.initials: EB
authors.lastname: Ringelstein
mesh_terms: D000208:Acute Disease; D000367:Age Factors; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage; D001161:Arteriosclerosis / Q000097:blood; D002545:Brain Ischemia / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D002343:Carotid Artery, Internal; D005260:Female; D006801:Humans; D020243:Infarction, Anterior Cerebral Artery / Q000097:blood* / Q000209:etiology*; D020244:Infarction, Middle Cerebral Artery / Q000097:blood / Q000209:etiology; D020766:Intracranial Embolism / Q000097:blood; D008297:Male; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D010959:Tissue Plasminogen Activator / Q000097:blood*; D014715:Vertebrobasilar Insufficiency / Q000097:blood / Q000150:complications
chemical_list: D000925:Anticoagulants; D017395:Plasminogen Activator Inhibitor 1; D010959:Tissue Plasminogen Activator