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Increased thromboxane biosynthesis is associated with poststroke dementia.

F van Kooten1, G Ciabattoni, P J Koudstaal

  • 1Department of Neurology, University Hospital Rotterdam, Rotterdam, the Netherlands. vankooten@neuro.fgg.eur.nl

Stroke
|August 6, 1999
PubMed
Summary
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Increased thromboxane biosynthesis after stroke is linked to dementia. This association is especially notable in aspirin users, suggesting non-platelet sources of thromboxane A(2) production.

Area of Science:

  • Neurology
  • Cardiovascular Medicine
  • Biochemistry

Background:

  • Daily aspirin intake may reduce cognitive decline, but the mechanism remains unclear.
  • Thromboxane A(2) (TXA(2)) is implicated in various physiological processes.
  • Investigating TXA(2) biosynthesis in post-stroke patients is crucial for understanding cognitive decline.

Purpose of the Study:

  • To examine the relationship between thromboxane A(2) biosynthesis and dementia in patients following acute stroke.
  • To determine if TXA(2) production differs between demented and non-demented post-stroke individuals.

Main Methods:

  • Patients from the Rotterdam Stroke Databank were screened for dementia 3-9 months post-stroke.
  • Urinary 11-dehydro-TXB(2) levels, a marker of TXA(2) biosynthesis, were measured using radioimmunoassay.

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  • Statistical analysis, including logistic regression, accounted for potential confounders like aspirin use and cardiovascular risk factors.

    • Main Results:

    • Dementia was diagnosed in 71 patients; urinary 11-dehydro-TXB(2) levels were significantly higher in demented patients compared to controls.
    • No significant difference in TXA(2) metabolite excretion was found between vascular dementia and Alzheimer's disease with cerebrovascular disease.
    • Increased urinary 11-dehydro-TXB(2) remained independently associated with dementia, particularly in ischemic stroke patients taking aspirin.

    Conclusions:

    • Elevated thromboxane biosynthesis in the chronic phase post-stroke is associated with the presence of dementia, irrespective of dementia type.
    • The heightened association in aspirin users suggests the involvement of extraplatelet TXA(2) production pathways.
    • These findings highlight a potential link between TXA(2) and post-stroke cognitive impairment.