FIBRINOLYTIC MEASUREMENTS IN TYPE-2 DIABETIC-PATIENTS WITH ACUTE CEREBRAL INFARCTION

The aim of this study was to investigate disturbances in fibrinolytic components in Type 2 diabetes patients with acute ischaemic stroke. Le vels of plasminogen activator inhibitor-1 (PAI-1) activity and tissue PA (t-PA) antigen were measured in Type 2 diabetes subjects with (n=40 ) and without (n=80) acute stroke compared to non-diabetic subjects wi th (n=80) and without (n=80) acute ischaemic stroke. Diabetes was defi ned by WHO criteria and absence of diabetes by blood glucose <7.8 mmol (-1) and HbA(1c) <6 % (reference range for assay 4.5-6.5 %). Levels of t-PA antigen were lower in healthy controls (9.2 ng ml(-1)) than in e ither stroke group (non-diabetic stroke patient: 12.6 ng ml(-1); diabe tic patient with stroke: 13.5 ng ml(-1) (each at p<0.05)) and intermed iate in diabetic patients without stroke (11.1 ng ml(-1), ns). In a re gression model levels of t-PA were related to stroke, BMI and age but not to diabetes or sex. Diabetic subjects without stroke had higher PA I-I activity levels than either non-diabetic group (17.7 Uml(-1) vs 12 .1 U ml(-1) and 9.2 U ml(-1) (each at p<0.05)). Levels were intermedia te in diabetic subjects with stroke (12.8 U ml(-1), ns). In a regressi on model levels of PAI-1 were related to Type 2 diabetes, female sex, and body mass index but not stroke or age. These data suggest that fur ther suppression of fibrinolysis does not occur with ischaemic stroke in Type 2 diabetes. The findings contrast with the importance of impai red fibrinolysis in coronary artery disease previously reported in bot h Type 2 diabetic patients and non-diabetic subjects. (C) 1998 John Wi ley & Sons, Ltd.