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. Levels 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 (r=80) acute stroke compared to non-diabetic subjects with (n=80) and without (n=80) acute ischaemic stroke. Diabetes was defined by WHO criteria and absence of diabetes by blood glucose <7.8 mmol(-1) and HbA(IC) <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 either stroke group (non-diabetic stroke patient: 12.6 ng ml(-1); diabetic patient with stroke: 13.5 ng ml(-1)(each at p<0.05)) and intermediate in diabetic patients without stroke (11.1 ng ml(-1), ns). In a regression model levels of t-PA were related to stroke, BMI and age but not to diabetes or sex. Diabetic subjects without stroke had higher PAI-1 activity levels than either non-diabetic group (17.7 U ml(-1) vs 12.1 U ml(-1) and 9.2 U ml(-1) (each at p<0.05)). Levels were intermediate in diabetic subjects with stroke (12.8 U ml(-1), ns). In a regression 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 further suppression of fibrinolysis does not occur with ischaemic stroke in Type 2 diabetes. The findings contrast with the importance of impaired fibrinolysis in coronary artery disease previously reported in both Type 2 diabetic patients and non-diabetic subjects.