Plasma fibrinolysis inhibitor levels in acute stroke patients with thrombolysis failure.
OBJECTIVE
Thrombolytics-induced recanalization fails in a significant portion of patients with ischemic stroke, which is partly due to the resistance of clots to lysis by thrombolytic agents. The pretreatment level of endogenous fibrinolysis inhibitors may affect such thrombolysis failure.


METHODS
We studied 43 stroke patients whose arterial recanalization had been evaluated by angiography, and whose blood had been obtained prior to the administration of thrombolytic agents. Plasma samples from 34 healthy volunteers were used as normal controls. Plasminogen activator inhibitor type 1 (PAI-1) and thrombin-activatable fibrinolysis inhibitor (TAFI) levels were quantified using an enzyme-linked immunosorbent assay.


RESULTS
Arteries were recanalized [Thrombolysis in Myocardial Infarction (TIMI) grade 2 or 3] in 30 patients, but not (TIMI grade 0 or 1) in the other 13. The plasma PAI-1 level was significantly higher in patients without recanalization (nonrecanalization) than in those with recanalization and in normal controls. The TAFI levels did not differ among the groups.


CONCLUSIONS
The pretreatment PAI-1 levels are increased in acute stroke patients with thrombolysis failure.
Kim
Seo Hyun
SH
Department of Neurology, Yonsei University Wonju College of Medicine, Korea.
Han
Sang Won
SW
Kim
Eun Hee
EH
Kim
Dong Joon
DJ
Lee
Kyung Yul
KY
Kim
Dong Ik
DI
Heo
Ji Hoe
JH
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