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The tissue factor pathway in ischemic stroke


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Adams, MJ and Thom, J and Hankey, GJ and Baker, RI and Gilmore, G and Staton, JM and Eikelboom, JW (2006) The tissue factor pathway in ischemic stroke. Blood Coagulation and Fibrinolysis, 17 (7). pp. 527-532. ISSN 0957-5235

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To explore the role of the the tissue factor (TF) pathway in ischemic stroke. We measured blood concentrations of markers of the TF pathway [TF antigen, free tissue factor pathway inhibitor antigen (TFPIf) and activity (TFPIac), and activated factor VII (FVIIa)] within 7 days (acute phase) and after 3-6 months (convalescence) in 150 patients with first-ever ischemic stroke and 150 community controls. During the acute phase, TF antigen and TFPIf were not significantly altered but TFPIac was increased (mean 1.27 versus 1.13 U/ml, P U 0.04) and FVIIa was decreased in cases compared with controls (mean 43.3 versus 57.9 mU/ml, P U 0.0004). After adjusting for baseline differences between cases and controls, increasing quartiles of TFPIf were independently associated with reduced odds of stroke, and reducing quartiles of FVIIa and increasing quartiles of TFPIac with increased odds of stroke. During the convalescent phase, FVIIa and TFPIac returned to normal but TF antigen and TFPIf were significantly decreased compared with controls [median TF antigen, 110 (follow-up) versus 155 pg/ml (controls), P U 0.0008; median TFPIf, 15.5 (follow-up) versus 23.3 ng/ml (controls), P U 0.002]. Alterations of blood concentrations of TF pathway markers are common in patients with acute ischemic stroke. The mechanisms are unclear but may relate to enhanced formation of TF-FVIIa complexes and upregulation and release of TFPI during the acute phase, and ongoing consumption of TF antigen and TFPIf during the chronic phase as the atherosclerotic plaque heals.

Item Type: Article
Keywords: tissue factor, stroke, factor VII, tissue factor pathway inhibitor
Journal or Publication Title: Blood Coagulation and Fibrinolysis
Page Range: pp. 527-532
ISSN: 0957-5235
Identification Number - DOI: 10.1097/01.mbc.0000245294.41774.06
Additional Information: The definitive version is available online at
Date Deposited: 27 Sep 2007
Last Modified: 18 Nov 2014 03:21
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