Immunotherapy blocking the tissue plasminogen activator-dependent activation of N-methyl-d-aspartate glutamate receptors improves hemorrhagic stroke outcome

Aim. To measure the indicators of the anticoagulant and fibrinolytic blood systems activity in patients with arterial hypertension after suffering a hemorrhagic stroke. Methods. 82 patients with arterial hypertension were examined at different terms after suffering a hemorrhagic stroke. Antithrombin III activity, total blood fibrinolytic activity and D-dimer levels, as well as tissue plasminogen activator activity and antigen levels were studied. Patients were examined at admission before standard treatment initiation and at discharge. Tissue plasminogen activator activity and its antigen level were determined at admission. Statistical data processing was performed using Statistica 8 (StatSoft) integrated package for Windows. Results. Inhibited fibrinolytic activity and an imbalance of its components, as well as reduced levels and activity of antithrombin III and signs of fibrin formation were revealed in patients with arterial hypertension stage III at different periods after suffering hemorrhagic stroke. Changes were most evident in early and late recovery periods after suffered cerebral stroke. Subsequent follow-up for over-a-year term after suffered cerebral stroke revealed a trend for normalization of these indicators. The study of tissue plasminogen activator activity and levels of its antigen showed significant changes in these parameters. Analysis of the obtained results for all patients with hypertension, regardless of the period of hemorrhagic stroke, showed the reduction of the antigen tissue plasminogen activator level and its increased activity. After in-patient treatment, there was a trend for improvement in all studied parameters without their complete normalization. Conclusion. The results suggest an activation of intravascular clotting in parients with arterial hypertension who suffered a hemorrhagic stroke, increasing the risk for further cardiovascular complications.

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Baseline Magnetic Resonance Imaging Parameters and Stroke Outcome in Patients Treated by Intravenous Tissue Plasminogen Activator

Stroke ◽

10.1161/01.str.0000053850.64877.af ◽

2003 ◽

Vol 34 (2) ◽

pp. 458-463 ◽

Cited By ~ 74

Author(s):

N. Nighoghossian ◽

M. Hermier ◽

P. Adeleine ◽

L. Derex ◽

J.F. Dugor ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Plasminogen Activator ◽

Tissue Plasminogen Activator ◽

Stroke Outcome ◽

Resonance Imaging ◽

Imaging Parameters ◽

Intravenous Tissue Plasminogen Activator ◽

Tissue Plasminogen

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After correcting for worse baseline characteristics, women treated with thrombolytic therapy for acute myocardial infarction have the same mortality and morbidity as men except for a higher incidence of hemorrhagic stroke. The Investigators of the International Tissue Plasminogen Activator/Streptokinase Mortality Study.

Circulation ◽

10.1161/01.cir.88.5.2097 ◽

1993 ◽

Vol 88 (5) ◽

pp. 2097-2103 ◽

Cited By ~ 98

Author(s):

H D White ◽

G I Barbash ◽

M Modan ◽

J Simes ◽

R Diaz ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Thrombolytic Therapy ◽

Plasminogen Activator ◽

Tissue Plasminogen Activator ◽

Hemorrhagic Stroke ◽

Mortality And Morbidity ◽

Mortality Study ◽

Tissue Plasminogen ◽

Baseline Characteristics

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Ischemic Stroke Outcome and Early Infection: Its Deleterious Effect Seems to Operate Also among Tissue Plasminogen Activator-Treated Patients

European Neurology ◽

10.1159/000322903 ◽

2011 ◽

Vol 65 (2) ◽

pp. 82-87 ◽

Cited By ~ 7

Author(s):

David Salat ◽

Pilar Delgado ◽

Sara Alonso ◽

Marc Ribó ◽

Estevo Santamarina ◽

...

Keyword(s):

Ischemic Stroke ◽

Plasminogen Activator ◽

Tissue Plasminogen Activator ◽

Deleterious Effect ◽

Early Infection ◽

Stroke Outcome ◽

Tissue Plasminogen

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Ten-Year Evaluation of the TOYOTA Prehospital Stroke Scale for Tissue Plasminogen Activator Intravenous Therapy in the Real World

Cerebrovascular Diseases ◽

10.1159/000494364 ◽

2018 ◽

Vol 46 (3-4) ◽

pp. 184-192

Author(s):

Junichiro Suzuki ◽

Noriyoshi Nakai ◽

Naohide Kondo ◽

Hirotake Tsuji ◽

Ryosuke Inagaki ◽

...

Keyword(s):

Atrial Fibrillation ◽

Ischemic Stroke ◽

Plasminogen Activator ◽

Tissue Plasminogen Activator ◽

Real World ◽

Hemorrhagic Stroke ◽

Multivariable Logistic Regression Analysis ◽

Intravenous Therapy ◽

The Real ◽

Tissue Plasminogen

Background: Emergency medical services are an important part of acute stroke management. We devised a prehospital stroke scale, the TOYOTA prehospital stroke scale for tissue plasminogen activator (t-PA) intravenous therapy (TOPSPIN) for triaging patients with ischemic stroke and especial indications for intravenous t-PA therapy in December 2006; this scale comprises 5 items including consciousness, atrial fibrillation, language disorder, disturbance of the upper extremities, and disturbance of the lower extremities. The aim of this study was to analyze the results of 10 years of TOPSPIN implementation and to distinguish ischemic stroke from hemorrhagic stroke in the real world. Methods: We prospectively enrolled consecutive patients who were transferred to our hospital and evaluated by Toyota city ambulance services using the TOPSPIN from December 2006 to January 2017. We examined definite diagnosis at the time of hospital discharge (ischemic stroke, hemorrhagic stroke, or stroke mimic), positive-predictive value of the stroke, the rate of the recanalization therapy, and clinical differentiation among patients with hemorrhagic stroke, ischemic stroke, and stroke mimics. Results: A total of 1,482 consecutive patients were enrolled; 1,134 (76.5%) were patients with stroke (628 ischemic-type, 34 transient ischemic attack-type, and 472 hemorrhagic-type) and 348 (23.5%) without stroke (80 with seizure, 42 with syncope, 27 with hypoglycemia, and 199 other). Among 628 patients with ischemic stroke, 130 (20.7%) received intravenous recombinant t-PA treatment, endovascular therapy, or both. The presence of atrial fibrillation, older age, lower blood pressure, and lower total TOPSPIN score was more commonly associated with ischemic stroke than with hemorrhagic stroke. In multivariable logistic regression analysis, the presence of atrial fibrillation was independently associated with ischemic stroke (OR 2.33; 95% CI 1.61–3.40). Conclusions: The TOPSPIN is a simple prehospital stroke scale that includes an assessment of atrial fibrillation. Detection of atrial fibrillation in the prehospital stage may point to a higher probability of ischemic stroke.

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