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Hypofibrinolytic and atherogenic risk factors for stroke

C J Glueck1, M H Rorick, M Schmerler

  • 1Cholesterol Center, Jewish Hospital, University of Cincinnati, OH 45229.

The Journal of Laboratory and Clinical Medicine
|March 1, 1995
PubMed

Insights

Hypofibrinolysis, a condition impairing blood clot breakdown, is common in stroke survivors and their families. This is linked to higher levels of plasminogen activator inhibitor activity, a key clot stabilizer.

Area of Science:

  • Cardiovascular Science
  • Hematology
  • Stroke Research

Background:

  • Stroke survivors often have underlying risk factors that are not fully understood.
  • Fibrinolysis, the process of breaking down blood clots, plays a critical role in vascular health.
  • Impaired fibrinolysis (hypofibrinolysis) may contribute to thrombotic events like stroke.

Purpose of the Study:

  • To determine the prevalence of hypofibrinolysis and related risk factors in stroke patients and their relatives.
  • To investigate the role of plasminogen activator inhibitor (PAI) and tissue plasminogen activator (t-PA) in stroke pathogenesis.
  • To assess familial clustering of hypofibrinolysis.

Main Methods:

  • Studied 87 stroke patients and 26 first-degree relatives.
  • Measured lipids, lipoprotein (a), basal and stimulated fibrinolytic activity, PAI activity, and t-PA antigen levels.
  • Compared findings with 175 normolipidemic control subjects.

Main Results:

  • Hypofibrinolysis was prevalent in 21% of stroke patients and 30% of relatives, significantly higher than controls.
  • Elevated basal PAI activity (major fibrinolysis inhibitor) was found in 20% of patients and 21% of relatives.
  • Higher mean basal PAI activity/antigen and t-PA antigen levels were observed in stroke patients compared to controls.

Conclusions:

  • Hypofibrinolysis is a common finding in stroke patients and their first-degree relatives.
  • This impairment is associated with increased PAI activity and potentially higher t-PA antigen levels.
  • These findings suggest a genetic or familial predisposition to hypofibrinolysis as a stroke risk factor.

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