HEMOSTATIC DISTURBANCES IN ACUTE ISCHEMIC STROKE - A STUDY OF 86 PATIENTS

The relevance of coagulation abnormalities in ischemic stroke remains uncertain. The purpose of this study was to identify abnormal patterns of coagulation in established ischemic stroke. We measured coagulatio n parameters in 86 patients with acute ischemic stroke: 10 lacunar, 55 atherothrombotic and 21 cardioembolic. Statistical comparisons mere m ade between different stroke groups and between all stroke patients an d 60 healthy controls. A decrease in functional antithrombin III and p lasminogen and an increase in thrombin-antithrombin III complexes, tot al protein S, tissue plasminogen activator, plasminogen activator inhi bitor and D-dimer were observed in the stroke group (p < 0.05). A posi tive correlation was found between tissue plasminogen activator and th rombin-antithrombin III levels in cardioembolic stroke (p < 0.05). Pro tein C levels showed significant differences between the three groups, and in the cardioembolic group they were lower than in controls (p < 0.05). Antiphospholipid antibodies were positive in two cases. We conc lude that activation of coagulation and fibrinolytic pathways was obse rved during the acute phase of ischemic stroke. Protein C activity is different in the three types of strokes analyzed, and higher levels se em to be associated with lacunar lesions. Antiphospholipid antibodies do not seem to play an important role in the pathogenesis of stroke in a nonselected population.