[Platelet hemostasis in patients with ischemic stroke after systemic thrombolytic therapy].
OBJECTIVE
To study the platelet aggregation (PA) in patients with ischemic stroke (IS) after systemic thrombolytic therapy (TLT).


METHODS
Twenty-four patients, including 13 with atherothrombotic IS and 11 with cardioembolic IS, have been examined after systemic TLT. Spontaneous and adrenaline-induced PA, international normalized ratio, activated partial thromboplastin time, fibrinogen, neurological deficit severity on the NIHSS (2nd, 6-7th, 12-14th and 21st days after TLT), computed tomography (CT) of the brain (at baseline and 2nd day after TLT) were assessed.


RESULTS
The correlation between TLT outcomes and characteristics of spontaneous and adrenaline-induced PA was shown. Patients with initially elevated PA (group 1, n=7) had the lowest NIHSS score in the 21st day. A group of patients with initially reduced PA (group 2, n=17) included a subgroup with no spontaneous aggregation (n=9) and a subgroup with hemostasis system dysregulation manifested with increased spontaneous PA and fibrinogen (n=8), in which the recovery of neurological functions was lower compared to group 1.


CONCLUSIONS
The results of the study can be used for individualization of preventive antiaggregative and anticoagulative therapy after TLT.
Pirogov Russian National Research Medical University.
A V
AV
Anisimova
Pirogov Russian National Research Medical University.
T I
TI
Kolesnikova
City Hospital #1, Moscow.
E V
EV
Juckova
City Hospital #1, Moscow.
P V
PV
Kapel'nickij
Pirogov Russian National Research Medical University.
S S
SS
Galkin
D001792:Blood Platelets / Q000187:drug effects / Q000502:physiology*; D002545:Brain Ischemia; D005340:Fibrinogen; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006487:Hemostasis; D006801:Humans; D010974:Platelet Aggregation; D020521:Stroke / Q000188:drug therapy* / Q000503:physiopathology; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D005343:Fibrinolytic Agents; D005340:Fibrinogen; D010959:Tissue Plasminogen Activator