title: Altered fibrin clot structure/function in patients with cryptogenic ischemic stroke.
abstract: OBJECTIVE
  We tested the hypothesis that fibrin structure/function is unfavorably altered in patients with cryptogenic ischemic stroke.
  
  
  METHODS
  Ex vivo plasma fibrin clot permeability, turbidimetry, and efficiency of fibrinolysis were determined in 89 patients with patent foramen ovale (PFO) and a history of first-ever stroke, 58 patients with first-ever stroke and no PFO, and 120 healthy controls.
  
  
  RESULTS
  Stroke patients, evaluated 3 to 19 months after the event, and controls did not differ with regard to age, sex, smoking, and fibrinogen. Stroke patients with or without PFO had lower clot permeability (P<0.0001), faster fibrin polymerization (P<0.0001), prolonged clot lysis time (P<0.0001), higher maximum D-dimer levels released from clots (P<0.0001), and maximum rate of D-dimer release (P=0.02) than controls. Time from stroke occurrence showed no association with any clot variables. Scanning electron microscopy of fibrin clots showed increased fiber diameter and density in stroke patients. Clots from stroke patients with PFO were more permeable and showed shorter lysis time compared to those without PFO, and this was related to lower proportion of smokers in the former group.
  
  
  CONCLUSIONS
  Altered fibrin clot structure and resistance to fibrinolysis are associated with cryptogenic stroke.
authors.affiliation: Institute of Cardiology, Jagiellonian University School of Medicine, Cracow, Poland. mmundas@cyf-kr.edu.pl
authors.forename: Anetta
authors.initials: A
authors.lastname: Undas
authors.forename: Piotr
authors.initials: P
authors.lastname: Podolec
authors.forename: Krystyna
authors.initials: K
authors.lastname: Zawilska
authors.forename: Monika
authors.initials: M
authors.lastname: Pieculewicz
authors.forename: Ireneusz
authors.initials: I
authors.lastname: Jedliński
authors.forename: Ewa
authors.initials: E
authors.lastname: Stepień
authors.forename: Ewa
authors.initials: E
authors.lastname: Konarska-Kuszewska
authors.forename: Przemysław
authors.initials: P
authors.lastname: Weglarz
authors.forename: Malłgorzata
authors.initials: M
authors.lastname: Duszyńska
authors.forename: Ewelina
authors.initials: E
authors.lastname: Hanschke
authors.forename: Tadeusz
authors.initials: T
authors.lastname: Przewlocki
authors.forename: Wiesława
authors.initials: W
authors.lastname: Tracz
mesh_terms: D000328:Adult; D001777:Blood Coagulation / Q000502:physiology*; D002545:Brain Ischemia / Q000097:blood*; D005260:Female; D005337:Fibrin / Q000378:metabolism*; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005342:Fibrinolysis / Q000502:physiology*; D054092:Foramen Ovale, Patent / Q000097:blood; D006801:Humans; D008297:Male; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D009391:Nephelometry and Turbidimetry; D010539:Permeability; D020521:Stroke / Q000097:blood*
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D005337:Fibrin