HEMOSTATIC MARKERS IN ACUTE TRANSIENT ISCHEMIC ATTACKS

Background and Purpose Hemostatic abnormalities have been shown previously in stroke patients. The purpose of this study was to assess the activity of selected parameters of the coagulation system in acute reversible cerebral ischemia. Methods We measured fibrinopeptide A, thrombin-antithrombin III, and D-dimer in 36 patients in both the acute (<7 days) and postacute stage (1 and 3 months) after a transient ischemic attack (TIA). The results were compared with those of 20 asymptomatic patients with a history of remote TIA and 65 age- and sex-matched controls. Results Mean fibrinopeptide A and thrombin-antithrombin III values were elevated in the acute stage after a TIA (P<.02) compared with levels at 1 month. In contrast, D-dimer was significantly increased at all three time points after the event when compared with remote TIA (P<.05) or control subjects (P<.001). No association could be found between marker levels and clinical outcome or the degree of cervical atherosclerosis as assessed by duplex ultrasonography. Conclusions These findings suggest that after acute reversible cerebral ischemia, there is early transient activation of thrombogenesis and ongoing fibrinolysis.