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

doi:10.1016/j.thromres.2021.03.028

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 journal › Article › Academic › peer-review

4 Citations (Web of Science)

Abstract

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 language	English
Pages (from-to)	139-144
Number of pages	6
Journal	Thrombosis Research
Volume	202
DOIs	https://doi.org/10.1016/j.thromres.2021.03.028
Publication status	Published - Jun 2021

Keywords

Thrombin generation
Ischemic stroke
Transient ischemic attack (TIA)
Young
Case-controls studies
PLATELET-RICH PLASMA
CARDIOVASCULAR-DISEASE
THROMBOGRAM
RISK
HYPERCOAGULABILITY
ATHEROSCLEROSIS
MECHANISMS
MUTATION
ADULTS

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10.1016/j.thromres.2021.03.028

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@article{9a47bf93ad45431ca23b1d6ec3078a80,

title = "Thrombin generation is associated with ischemic stroke at a young age",

abstract = "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.",

keywords = "Thrombin generation, Ischemic stroke, Transient ischemic attack (TIA), Young, Case-controls studies, PLATELET-RICH PLASMA, CARDIOVASCULAR-DISEASE, THROMBOGRAM, RISK, HYPERCOAGULABILITY, ATHEROSCLEROSIS, MECHANISMS, MUTATION, ADULTS",

author = "Donkel, {Samantha J.} and Karmen Pater and Leebeek, {Frank W. G.} and Dippel, {Diederik W. J.} and {Ten Cate}, Hugo and {de Maat}, {Moniek P. M.}",

note = "Funding Information: The ATTAC study was supported by a MRACE grant of the Erasmus MC, Rotterdam, the Netherlands. We acknowledge the support of the Netherlands Cardiovascular Research Initiative which is supported by the Dutch Heart Foundation (CVON2015-01: CONTRAST), the support of the Brain Foundation Netherlands (HA2015.01.06), and the support of Health~Holland, Top Sector Life Sciences & Health (LSHM17016), Medtronic and Cerenovus. The collaboration project is additionally financed by the Ministry of Economic Affairs by means of the PPP Allowance made available by the Top Sector Life Sciences & Health to stimulate public-private partnerships. Publisher Copyright: {\textcopyright} 2021",

year = "2021",

month = jun,

doi = "10.1016/j.thromres.2021.03.028",

language = "English",

volume = "202",

pages = "139--144",

journal = "Thrombosis Research",

issn = "0049-3848",

publisher = "Elsevier Science",

}

TY - JOUR

T1 - Thrombin generation is associated with ischemic stroke at a young age

AU - Donkel, Samantha J.

AU - Pater, Karmen

AU - Leebeek, Frank W. G.

AU - Dippel, Diederik W. J.

AU - Ten Cate, Hugo

AU - de Maat, Moniek P. M.

N1 - Funding Information: The ATTAC study was supported by a MRACE grant of the Erasmus MC, Rotterdam, the Netherlands. We acknowledge the support of the Netherlands Cardiovascular Research Initiative which is supported by the Dutch Heart Foundation (CVON2015-01: CONTRAST), the support of the Brain Foundation Netherlands (HA2015.01.06), and the support of Health~Holland, Top Sector Life Sciences & Health (LSHM17016), Medtronic and Cerenovus. The collaboration project is additionally financed by the Ministry of Economic Affairs by means of the PPP Allowance made available by the Top Sector Life Sciences & Health to stimulate public-private partnerships. Publisher Copyright: © 2021

PY - 2021/6

Y1 - 2021/6

N2 - 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.

AB - 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.

KW - Thrombin generation

KW - Ischemic stroke

KW - Transient ischemic attack (TIA)

KW - Young

KW - Case-controls studies

KW - PLATELET-RICH PLASMA

KW - CARDIOVASCULAR-DISEASE

KW - THROMBOGRAM

KW - RISK

KW - HYPERCOAGULABILITY

KW - ATHEROSCLEROSIS

KW - MECHANISMS

KW - MUTATION

KW - ADULTS

U2 - 10.1016/j.thromres.2021.03.028

DO - 10.1016/j.thromres.2021.03.028

M3 - Article

C2 - 33838480

SN - 0049-3848

VL - 202

SP - 139

EP - 144

JO - Thrombosis Research

JF - Thrombosis Research

ER -