Thrombin generation is associated with ischemic stroke at a young age

Samantha J. Donkel, Karmen Pater, Frank W. G. Leebeek, Diederik W. J. Dippel, Hugo Ten Cate, Moniek P. M. de Maat*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Web of Science)


Introduction: Understanding the underlying mechanisms in ischemic stroke (IS) in young adults remains challenging. Thrombin activates processes that contribute to the development and progression of arterial diseases. We investigated the association between thrombin generation (TG) and a first IS or transient ischemic attack (TIA) in young adults.

Methods: In this case-control study, we included consecutive patients (

Results: TG started earlier, reached its peak earlier and was also terminated earlier in patients than in healthy controls. Peak height (PH) was higher in patients than in controls, 227 nM (25th-75th percentile 145-326) versus 179 nM (110-294), p = 0.02. The endogenous thrombin potential (ETP) was not different in patients and controls, 1530 nM center dot min (1089-2045) versus 1454 nM center dot min (1011-2139), p = 0.52. Lag time (LT) (Odds Ratio (OR) 0.91 (95% confidence interval (CI) 0.83-0.99)), time to peak (TTP) (OR 0.91, 95% CI 0.84-0.97) and time to tail (TTT) (OR 0.92, 95% CI 0.88-0.97) were associated with a first IS and TIA. In men LT, TTP and TTT were associated with IS, but not in women.

Conclusions: We found that TG parameters are associated with a first IS in young patients. Further prospective studies are warranted to elucidate the role of TG in IS.

Original languageEnglish
Pages (from-to)139-144
Number of pages6
JournalThrombosis Research
Publication statusPublished - Jun 2021


  • Thrombin generation
  • Ischemic stroke
  • Transient ischemic attack (TIA)
  • Young
  • Case-controls studies
  • RISK

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