Platelet hemostasis in patients with ischemic stroke after systemic thrombolytic therapy

Abstract

To study the platelet aggregation (PA) in patients with ischemic stroke (IS) after systemic thrombolytic therapy (TLT). Twenty-four patients, including 13 with atherothrombotic IS and 11 with cardioembolic IS, have been examined after systemic TLT. Spontaneous and adrenaline-induced PA, international normalized ratio, activated partial thromboplastin time, fibrinogen, neurological deficit severity on the NIHSS (2nd, 6-7th, 12-14th and 21st days after TLT), computed tomography (CT) of the brain (at baseline and 2nd day after TLT) were assessed. The correlation between TLT outcomes and characteristics of spontaneous and adrenaline-induced PA was shown. Patients with initially elevated PA (group 1, n=7) had the lowest NIHSS score in the 21st day. A group of patients with initially reduced PA (group 2, n=17) included a subgroup with no spontaneous aggregation (n=9) and a subgroup with hemostasis system dysregulation manifested with increased spontaneous PA and fibrinogen (n=8), in which the recovery of neurological functions was lower compared to group 1. The results of the study can be used for individualization of preventive antiaggregative and anticoagulative therapy after TLT.