Thrombin generation is associated with ischemic stroke at a young age.

Abstract

INTRODUCTION\nUnderstanding 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.\n\n\nMETHODS\nIn this case-control study, we included consecutive patients (≤45\xa0years in men, ≤55\xa0years in women) with a first IS or TIA (n\xa0=\xa0160) and healthy controls (n\xa0=\xa0160). TG was determined with the calibrated automated thrombogram (CAT) assay. Logistic regression was used to analyze the association between TG and IS. Men and women were analyzed separately.\n\n\nRESULTS\nTG 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\xa0nM (25th-75th percentile 145-326) versus 179\xa0nM (110-294), p\xa0=\xa00.02. The endogenous thrombin potential (ETP) was not different in patients and controls, 1530\xa0nM·min (1089-2045) versus 1454\xa0nM·min (1011-2139), p\xa0=\xa00.52. 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.\n\n\nCONCLUSIONS\nWe 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.