[Hemostatic markers of endothelial injury in ischaemic stroke caused by large or small vessel disease].

THE AIM

of the study was to compare hemostatic markers of endothelial injury in patients with ischaemic stroke caused by large vessel disease (LVD) or small vessel disease (SVD).

MATERIAL AND METHODS

We studied 30 patients with LVD and 41 patients with SVD (recruited out of 585 patients with ischaemic stroke) as well as 30 control subjects. Etiology of ischaemic stroke was established according to the TOAST criteria. In patients being 3-12 months after stroke we registered age, sex and the presence of common risk factors for stroke. We measured serum concentration of fibrinogen and plasminogen activator inhibitor 1 (PAI-1), activity of von Willebrand factor (vWF) and the level of beta-thromboglobulin (beta-TG).

RESULTS

The concentration of fibrinogen was greater in patients with LVD (3.56 +/-0.88 g/L) when compared to patients with SVD (2.78 +/-0.69 g/L, p<O.0005). Activity of vWF was higher in all stroke survivors (155.8+/-53.9%) when compared to controls (124.8+/-43.3%; p<0.01). It was also higher in patients with LVD (179.9+/-53.6%) than in patients with SVD (139.3+/-48. 1%; p<O.01). The level of /-TG in patients with LVD [192.0 (69.7-222.1) UI/mL] was higher than in patients with SVD [90.6 (56.6-165.8) UI/mL; p<0.05] and higher than in controls [108.7 (49.0-166.5) Ul/mL, p<0.05]. The concentration of PAl-1 was similar among all studied groups.

CONCLUSIONS

Stroke patients with LVD are characterized by higher concentration of fibrinogen, higher activity of vWF and higher levels of (Beta-TG) than patients with SVD. PAI-1 concentration is similar in both groups. Our results confirm the need for reanalysis of risk factors and pathomechanism of each cause of stroke separately.