Abnormalities in Clotting and Thrombolysis as a Risk Factor for Stroke

Summary

Four hundred and six patients with ischemic thrombotic cerebrovascular disease (ITCVD) and 115 age-matched controls were studied to select risk factors which would identify ITCVD-prone individuals from a healthy population. The following factors were evaluated : soluble fibrin, plasminogen, plasminogen activator, fibrinogen, partial thromboplastin time, generation of thromboplastin, fibrin degradation products, triglycerides, type IV lipoproteinemia, and cholesterol. Discriminate function analyses were used to select those risk factors which best separate and classify the ITCVD and control subjects. The primary risk factors are the activated partial thromboplastin time, soluble fibrin, fibrinogen, and plasminogen activator. Utilizing only these four primary risk factors in a discriminate function, 93.2% of the patients were correctly classified. Consideration of other variables increased still further the dis-criminate function.

• References

• 1 Aggeler P. M, Kosmin M. Anticoagulation prophylaxis and treatment of venous thromboembolic disease. Thrombosis—National Academy of Sciences. 1969: 639
• 2 Alkjaersig N, Fletcher A. P, Sherry S. E-Aminocaproic acid: an inhibitor of plasminogen activation. Journal of Biological Chemistry 1959; 234: 832
• 3 Chaeytan C, Purtilo D. Glomerular capillary thrombosis and acute renal failure after E-Aminocaproic acid therapy. New England Journal of Medicine 1969; 280: 1102
• 4 Douglas A. S. 1969; Anticoagulant therapy in coronary artery disease. Thrombosis-National Academy of Sciences 690
• 5 Fearnley G. R. Measurement of spontaneous fibrinolytic activity. Journal of Clinical Pathology 1964; 17: 307
• 6 Fearnley G. R. 1970; Fibrinolysis and its pharmacological enhancement in occlusive vascular disease. Advances in Cardiology 4: 211
• 7 Gibinski K. Atherosclerose et coagulation. Revue Francaise d’études Cliniques et Biologiques 1966; 11: 185
• 8 Hampton J. W, Mantooth J, Brandt E. N, Wolf Jr S. G. 1966; Plasma fibrinogen patterns in patients with coronary atherosclerosis. Circulation 34: 1098
• 9 Hensen A, Kroes F, van Dyke L, Fekkes N, Hemker H, Loeliger E. A. A double blind study of phenprocoumon prophylaxis after a myocardial infarction. Thrombosis et Diathesis Haemorrhagica 1966; suppl 21: 333
• 10 Kessler G, Lederer H. Fluorometic measurements of triglycerides. Analytical Chemistry. Technicon Symposium. M. I., N. Y. 1965
• 11 Kipshidze N. N, Tordiya M. B, Dzhavakhishvili N. N. Changes in the blood system in longevity. Federation Proceedings (Abstract) 1964; 23: 1247
• 12 Kisker C. D, Rush R. Detection of intravascular coagulation. Journal of Clinical Investigation 1971; 50: 2235
• 13 Loewy A. G, Dunathan K, Kriel R, Woleinger Jr H. L. 1961; Fibrinase: Purification of substrate and enzyme. Journal of Biological Chemistry 236: 2625
• 14 Merskey C. G, Kleiner J, Johnson A.J. Quantitative estimation of split products of fibrinogen in human serum: relation to diagnosis and treatment. Blood 28: 1
• 15 Merskey C, Johnson A. J. 1966; Diagnosis and treatment of intravascular coagulation. Thrombosis et Diathesis Haemorrhagica 1966; supp 21: 555
• 16 Mertens B. F, McDuffie F. C, Bowie J. W, Owen Jr. C. A. Rapid sensitive method for measuring fibrinogen split products in human serum. Mayo Clinic Proceedings 1969; 44: 114
• 17 Murphy E. A, Mustard J. F. 1962; Coagulation test and platelet economy in atherosclerotic and control subjects. Circulation 25: 114
• 18 Niewiarowski S, Wolosowicz N. The In-Vivo effect of E-Aminocaproic acid on the human plasma fibrinolytic system. Thrombosis et Diathesis Haemorrhagica 1966; 15: 491
• 19 Owen Jr. C. A, Didisheim P, Thompson Jr. J. H, Spittel Jr. J.A. Factor VIII and TGA types of hypercoagulability. Thrombosis -National Academy of Sciences. 1969: 573
• 20 Pascuzzi C. A, Spittel Jr. J, Thompson Jr. J. H, Owen Jr. C. A. Thromboplastin generation accelerator. a newly recognized component of the blood coagulation mechanism present in excess in certain thrombotic states. Journal of Clinical Investigation 1961; 40: 1006
• 21 Penick G. D. Blood states that predispose to thrombosis. Thrombosis-National Academy of Sciences. 1969: 553
• 22 Penick G. D, Dejanov I. I, Roberts H. R, Webster W. P. Elevation of factor VIII in hypercoagulable states. In Koller F. (Ed.) Diffuse Intravascular Clotting: F. K. Schattauer (Stuttg.); 1965: 39
• 23 Pilgeram L. O. 1961; The relation of plasma fibrinogen concentration changes to human atherosclerosis. Journal of Applied Physiology 16: 660
• 24 Pilgeram L. O. Turnover rate of autologous plasma fibrinogen ¹⁴C in subjects with coronary thrombosis. Thrombosis et Diathesis Haemorrhagica 1968; 20: 31
• 25 Pilgeram L. O, Amundson B, Lofgren P. E. Evidence for steroid control of the metabolism of Profibrinolysin. Thrombosis et Diathesis Haemorrhagica 1964; 11: 94
• 26 Pilgeram L. O, Commers L. R. Oxalate induced correction of the plasma antithromboplastin deficiency in the aging arteriosclerotic subject. Thrombosis et Diathesis Haemorrhagica 1964; 10: 350
• 27 Pilgeram L. O, Pickart L. R. Control of fibrinogen biosynthesis: The role of the free fatty acid. Journal of Atherosclerosis Research 1968; 8: 155-166.
• 28 Pilgeram L. O, SchrAm A. C. Correlation of activity changes in blood coagulation factors with human arteriosclerosis. Circulation (Abstract) 1959; 20: 991
• 29 Pilgeram L. O, SchrAm A. C, Loegering D. A. Elevation of plasma antithrombin in the aging arteriosclerotic subject. Journal of Applied Physiology 1963; 18: 329
• 30 Pilgeram L. O, SchrAm A. C, Mills D. Specificity of plasma fibrinogen changes in arterosclerosis. Circulation (Abstract) 1960; 22: 668
• 31 Procedure N 24a. Auto Analyzer Manual. Chauncey. New York: Technicon Instruments.; 1964
• 32 Proctor R. R, Rapaport S. I. The partial thromboplastin time with Kaolin. American Journal of Clinical Pathology 1961; 36: 212
• 33 Remue W. Thromboseprophylaxe bei kardialer Dekompensation. Medizinische Monatsschrift 1961; 15: 380
• 34 Schmid H. J, Jackson D. P, Conley C. L. Mechanism of action of thrombin on platelets. Journal of Clinical Investigation 1961; 41: 543
• 35 Spittel J. A, Pacuzzi C. A, Thompson J. H, Owen Jr. C. A. Acceleration of early stages of coagulation in certain patients with occlusive arterial or venous diseases : Use of a modified thromboplastin generation test to evaluate clot acceleration. Proceedings of the Mayo Clinic 1960; 35: 37
• 36 Steinmann B. Über Beziehungen zwischen Cholesterin- und Fibrinogen-Gehalt. Thromboembolien und Atherosklerose. Gerontología 1965; 10: 100
• 37 World Health Organization 1970; 43: 891
• 38 Worowski K, Niewiarowski S, Prokopowicz J. Fibrinolysis and fibrinogen breakdown products in renal venous blood in dog. Thrombosis et Diathesis Haemorrhagica 1964; 12: 87