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Quantitatively monitoring acute ischemic stroke patients post recombinant tissue plasminogen activator treatment.


ABSTRACT:

Background and aims

Thrombolytic therapy is widely used to treat acute ischemic stroke (AIS) patients. As intracerebral hemorrhage is a life-threatening complication of this therapy, monitoring the fibrinolytic and coagulation systems is imperative. However, existing studies on plasmin inhibitor complex (PIC) and thrombin-antithrombin III complex (TAT) mostly apply the enzyme-linked immunosorbent assay (ELISA) method. The aim of this study is to establish the baseline of thrombolytic treatment for AIS patients; to monitor the fibrinolytic and coagulation system following alteplase administration; to ascertain the proper time point to predict intracerebral hemorrhage.

Methods

The method used to assess a patient's intravascular situation, namely chemiluminescence, was used to quantitatively assess the PIC, TAT, and thrombomodulin (TM). Immuno-turbidimetric was used to assess the concentration of D-dimer, fibrin/fibrinogen degradation products (FDP), and the Von Willebrand factor (vWF). The Clauss clotting method was used to assay the activated partial thromboplastin time (APTT), prothrombin time (PT) and FIB.

Results

PIC increased to its peak concentration at 3?hours post intravenous (IV) alteplase infusion and decreased by nearly 50% every 3?hours thereafter. After 24?hours, PIC returned to its normal range, while D-dimer and FDP decreased 3?hours later compared to PIC. PT and APTT exhibited no obvious change during the 24-hour period. TM also exhibited no changes during the treatment.

Conclusion

PIC decreased 3?hours earlier than D-dimer and FDP. The combined test of PIC, D-dimer, and fibrinogen can be used to monitor the fibrinolytic system after the IV alteplase infusion. The use of IV alteplase had no impact on the endothelium. Creating a patient's individual data curve could assist in the prediction of hemorrhagic transformation (HT) and a stroke occurring.

SUBMITTER: Liu Y 

PROVIDER: S-EPMC7752160 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

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Publications

Quantitatively monitoring acute ischemic stroke patients post recombinant tissue plasminogen activator treatment.

Liu Yonge Y   Ma Jingting J   Shi Qiyang Q   Xin Shimeng S   Yu Haojia H   Liu Zilong Z   Pang Chunsong C   Dong Feng F   Wang Jinghan J  

Health science reports 20201221 1


<h4>Background and aims</h4>Thrombolytic therapy is widely used to treat acute ischemic stroke (AIS) patients. As intracerebral hemorrhage is a life-threatening complication of this therapy, monitoring the fibrinolytic and coagulation systems is imperative. However, existing studies on plasmin inhibitor complex (PIC) and thrombin-antithrombin III complex (TAT) mostly apply the enzyme-linked immunosorbent assay (ELISA) method. The aim of this study is to establish the baseline of thrombolytic tre  ...[more]

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