title: Shortened Activated Partial Thromboplastin Time Is Associated With Acute Ischemic Stroke, Stroke Severity, and Neurological Worsening.
abstract: BACKGROUND
  The role played by hemostasis in the pathogenesis of ischemic strokes is still controversial. The activated partial thromboplastin time (APTT) measures the time necessary to generate fibrin from initiation of the intrinsic pathway. In the present study, we looked for a possible association of ischemic strokes with the shortened APTT.
  
  
  METHODS
  The study population consisted of 154 patients with acute ischemic strokes who had been admitted from December 2013 to December 2014 to the Department of Neurology, Chiayi Chang Gung Memorial Hospital, and 71 control subjects with no history of stroke.
  
  
  RESULTS
  In a univariate risk analysis, shortened APTT was associated with an odds ratio (OR) for acute ischemic strokes of up to 1.86 (95% confidence interval [CI], 1.06-3.29, P = .031). In a multivariate analysis using a logistic regression model including age, sex, hypertension, diabetes mellitus, and shortened APTT, shortened APTT was still found to significantly add to the risk of ischemic stroke (OR = 2.12 with 95% CI, 1.13-3.98, P = .020). Shortened APTT was also associated significantly with neurological worsening (OR = 3.72 with 95% CI 1.03-13.5, P = .046). As for stroke severity, shortened APTT was associated with an OR for moderate/severe stroke of up to 3.42 (95% CI, 1.53-7.61, P = .003).
  
  
  CONCLUSIONS
  Shortened APTT is a prevalent and independent risk factor for ischemic stroke, stroke severity, and neurological worsening after acute stroke.
authors.affiliation: Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Taiwan.
authors.forename: Chun-Hsien
authors.initials: CH
authors.lastname: Lin
authors.affiliation: Department of Nursing, Asia University, Taichung, Taiwan.
authors.forename: Ya-Wen
authors.initials: YW
authors.lastname: Kuo
authors.affiliation: Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Taiwan.
authors.forename: Chih-Yu
authors.initials: CY
authors.lastname: Kuo
authors.affiliation: Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Taiwan; School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Yen-Chu
authors.initials: YC
authors.lastname: Huang
authors.affiliation: Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Taiwan.
authors.forename: Chia-Yu
authors.initials: CY
authors.lastname: Hsu
authors.affiliation: Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Taiwan.
authors.forename: Huan-Lin
authors.initials: HL
authors.lastname: Hsu
authors.affiliation: Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Taiwan.
authors.forename: Ya-Hui
authors.initials: YH
authors.lastname: Lin
authors.affiliation: Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Taiwan.
authors.forename: Chih-Ying
authors.initials: CY
authors.lastname: Wu
authors.affiliation: Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Taiwan.
authors.forename: Ying-Chih
authors.initials: YC
authors.lastname: Huang
authors.affiliation: Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Taiwan; School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Meng
authors.initials: M
authors.lastname: Lee
authors.affiliation: Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Taiwan.
authors.forename: Hsin-Ta
authors.initials: HT
authors.lastname: Yang
authors.affiliation: Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Taiwan.
authors.forename: Yi-Ting
authors.initials: YT
authors.lastname: Pan
authors.affiliation: Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Taiwan; School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Life Science, National Chung Cheng University, Chiayi, Taiwan. Electronic address: jdlee540908@gmail.com.
authors.forename: Jiann-Der
authors.initials: JD
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications; D005260:Female; D006801:Humans; D008074:Lipoproteins / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology*; D010314:Partial Thromboplastin Time; D012189:Retrospective Studies; D020521:Stroke / Q000150:complications* / Q000209:etiology; D013925:Thromboplastin / Q000378:metabolism*; D013997:Time Factors
chemical_list: D008074:Lipoproteins; D013925:Thromboplastin
keywords: Stroke; activated partial thromboplastin time; association; ischemic; risk