HEMOSTATIC MARKERS IN ACUTE TRANSIENT ISCHEMIC ATTACKS

Background and Purpose Hemostatic abnormalities have been shown previo usly in stroke patients. The purpose of this study was to assess the a ctivity of selected parameters of the coagulation system in acute reve rsible cerebral ischemia. Methods We measured fibrinopeptide A, thromb in-antithrombin III, and D-dimer in 36 patients in both the acute (<7 days) and postacute stage (1 and 3 months) after a transient ischemic attack (TIA). The results were compared with those of 20 asymptomatic patients with a history of remote TIA and 65 age- and sex-matched cont rols. Results Mean fibrinopeptide A and thrombin-antithrombin III valu es were elevated in the acute stage after a TIA (P<.02) compared with levels at 1 month. In contrast, D-dimer was significantly increased at all three time points after the event when compared with remote TIA ( P<.05) or control subjects (P<.001). No association could be found bet ween marker levels and clinical outcome or the degree of cervical athe rosclerosis as assessed by duplex ultrasonography. Conclusions These f indings suggest that after acute reversible cerebral ischemia, there i s early transient activation of thrombogenesis and ongoing fibrinolysi s.