title: Risk of ischemic stroke associated with functional thrombin-activatable fibrinolysis inhibitor plasma levels.
abstract: OBJECTIVE
  Recently, a novel procarboxypeptidase B-like proenzyme, called thrombin-activatable fibrinolysis inhibitor (TAFI), has been described. It plays an important role in the delicate balance between coagulation and fibrinolysis. TAFI leads to potent inhibition of tissue plasminogen activator-induced fibrinolysis. The relevance of TAFI in thromboembolic disease is unclear. We have investigated the risk of ischemic stroke (IS) in relation to plasma levels of functional TAFI.
  
  
  METHODS
  In a case-control study, we enrolled 264 individuals; 114 had IS, and 150 were recruited as controls who were age and sex matched and had no history of arterial disease. The individuals supplied information on their personal and family histories of cardiovascular diseases and conventional cardiovascular risk factors. Functional TAFI assays were performed by use of a method based on the activation of TAFI with thrombin-thrombomodulin and the measure of the TAFI activity generated. Other hemostatic parameters assayed were factor VIIIc, anti-phospholipid antibodies,fibrinogen, factor V Leiden, and the prothrombin gene G20210A mutations (PT20210A).
  
  
  RESULTS
  Functional TAFI levels were significantly higher in patients with IS (113.7+/-25%; range, 57% to 209%) than in controls (102.6+/-19%). The odds ratio for IS in patients with functional TAFI levels >120% was 5.7 (95% confidence interval, 2.3 to 14.1).
  
  
  CONCLUSIONS
  We found that functional TAFI levels in plasma (>120%) increased the risk of IS approximately 6-fold. Further studies should elucidate the physiological role of TAFI in arterial disease and possibly provide clues to therapeutic approaches.
authors.affiliation: Department of Hematology, Hospital de la Santa Creu i Sant Pau, C/ Sant Antoni Ma Claret, 167, 08025-Barcelona, Spain. msantamaria@hsp.santpau.es
authors.forename: A
authors.initials: A
authors.lastname: Santamaría
authors.forename: A
authors.initials: A
authors.lastname: Oliver
authors.forename: M
authors.initials: M
authors.lastname: Borrell
authors.forename: J
authors.initials: J
authors.lastname: Mateo
authors.forename: R
authors.initials: R
authors.lastname: Belvis
authors.forename: J
authors.initials: J
authors.lastname: Martí-Fábregas
authors.forename: R
authors.initials: R
authors.lastname: Ortín
authors.forename: I
authors.initials: I
authors.lastname: Tirado
authors.forename: J C
authors.initials: JC
authors.lastname: Souto
authors.forename: J
authors.initials: J
authors.lastname: Fontcuberta
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000097:blood* / Q000453:epidemiology*; D025901:Carboxypeptidase B2 / Q000097:blood*; D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D017678:Sex Distribution; D013030:Spain / Q000453:epidemiology; D020521:Stroke / Q000097:blood* / Q000453:epidemiology*
chemical_list: D025901:Carboxypeptidase B2