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Thrombin generation in acute cardioembolic and non-cardioembolic ischemic stroke

Elisabeth Rooth1, Piotr Sobocinski-Doliwa, Jovan Antovic

  • 1Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital.

Scandinavian Journal of Clinical and Laboratory Investigation
|September 26, 2013
PubMed

Insights

Thrombin generation is higher in patients with ischemic stroke, particularly cardioembolic stroke, compared to healthy individuals. Further research is needed to understand its long-term prognostic value in stroke patients.

Area of Science:

  • Cardiovascular Medicine
  • Hematology
  • Neurology

Background:

  • Increased thrombin generation, measured by Calibrated Automated Thrombogram (CAT), may predict ischemic stroke, especially cardioembolic stroke.
  • Limited studies exist on thrombin generation using CAT in patients with manifest ischemic stroke, particularly those with cardioembolic stroke not yet on anticoagulation.

Purpose of the Study:

  • To investigate thrombin generation using CAT in patients with acute ischemic stroke or TIA without a history of atrial fibrillation.
  • To compare thrombin generation levels between stroke patients and healthy controls.

Main Methods:

  • Prospective cohort study of 205 stroke patients (>45 years) without prior atrial fibrillation (AF).
  • Patients used a thumb ECG device to detect silent AF.
  • Thrombin generation was assessed using CAT at inclusion and 1 month post-stroke.

Main Results:

  • Stroke patients exhibited significantly higher peak thrombin concentrations compared to controls (p < 0.0001).
  • Thrombin generation levels were highest in patients who were subsequently diagnosed with paroxysmal AF.
  • Peak thrombin concentrations varied among stroke patients.

Conclusions:

  • Thrombin generation is elevated in patients with acute cardioembolic and non-cardioembolic ischemic stroke/TIA compared to healthy subjects.
  • The long-term prognostic significance of thrombin generation in recent ischemic stroke patients warrants further investigation.
Abstract

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