title: Plasma tPA-Activity and Progression of Cerebral White Matter Hyperintensities in Lacunar Stroke Patients.
abstract: BACKGROUND
  Tissue plasminogen activator (tPA)-activity and plasminogen activator inhibitor type 1 (PAI-1) antigen are considered to be haemostasis-related markers of endothelial activation and relate to presence of cerebral white matter hyperintensities (WMH) as was earlier shown in a cross-sectional study. We investigated whether tPA-activity and PAI-1 levels are associated with WMH progression in a longitudinal study.
  
  
  METHODS
  In 127 first-ever lacunar stroke patients in whom baseline brain MRI and plasma levels of tPA-activity and PAI-1-antigen were available, we obtained a 2-year follow-up MRI. We assessed WMH progression by a visual WMH change scale. We determined the relationship between levels of tPA-activity and PAI-1 and WMH progression, by logistic regression analysis.
  
  
  RESULTS
  Plasma tPA-activity was associated with periventricular WMH progression (OR 2.36, 95% CI 1.01-5.49, with correction for age and sex and baseline presence of WMH), but not with deep or any (periventricular and/or deep) WMH progression. PAI-1 levels were lower in patients with WMH progression, but these results were not significant.
  
  
  CONCLUSIONS
  We found a relationship between plasma tPA-activity and progression of periventricular WMH. More research is needed to determine whether there is a (direct) role of tPA in the development and progression of WMH.
authors.affiliation: Department of Neurology, Maastricht University Medical Centre (MUMC), Maastricht, the Netherlands.
authors.forename: Ellen C
authors.initials: EC
authors.lastname: van Overbeek
authors.affiliation: Department of Neurology, Maastricht University Medical Centre (MUMC), Maastricht, the Netherlands.|Cardiovascular Research Institute Maastricht, MUMC, Maastricht, the Netherlands.
authors.forename: Julie
authors.initials: J
authors.lastname: Staals
authors.affiliation: Department of Neurology, Medisch Spectrum Twente, Enschede, the Netherlands.
authors.forename: Iris L H
authors.initials: IL
authors.lastname: Knottnerus
authors.affiliation: Cardiovascular Research Institute Maastricht, MUMC, Maastricht, the Netherlands.|Department of Internal Medicine, MUMC, Maastricht, the Netherlands.
authors.forename: Hugo
authors.initials: H
authors.lastname: ten Cate
authors.affiliation: Department of Neurology, Maastricht University Medical Centre (MUMC), Maastricht, the Netherlands.|Cardiovascular Research Institute Maastricht, MUMC, Maastricht, the Netherlands.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: van Oostenbrugge
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D006487:Hemostasis; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000378:metabolism; D012044:Regression Analysis; D059409:Stroke, Lacunar / Q000097:blood* / Q000473:pathology*; D010959:Tissue Plasminogen Activator / Q000097:blood*; D066127:White Matter / Q000473:pathology*
chemical_list: D017395:Plasminogen Activator Inhibitor 1; C051321:SERPINE1 protein, human; D010959:Tissue Plasminogen Activator