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The tissue factor pathway in ischemic stroke


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Adams, MJ, Thom, J, Hankey, GJ, Baker, RI, Gilmore, G, Staton, JM and Eikelboom, JW 2006 , 'The tissue factor pathway in ischemic stroke' , Blood Coagulation and Fibrinolysis, vol. 17, no. 7 , pp. 527-532 , doi: 10.1097/01.mbc.0000245294.41774.06.

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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
Authors/Creators:Adams, MJ and Thom, J and Hankey, GJ and Baker, RI and Gilmore, G and Staton, JM and Eikelboom, JW
Keywords: tissue factor, stroke, factor VII, tissue factor pathway inhibitor
Journal or Publication Title: Blood Coagulation and Fibrinolysis
ISSN: 0957-5235
DOI / ID Number: 10.1097/01.mbc.0000245294.41774.06
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