Fibrin Clot Properties in Acute Stroke

Abstract

Background and Purpose-Fibrin clot formation is important in acute intracerebral hemorrhage (ICH). We investigated plasma fibrin clot characteristics in acute ICH compared with acute ischemic stroke (IS) and nonstroke conditions. Methods-In the 3 studied groups, we analyzed plasma fibrin clot phenotype and its association with clinical stroke presentation. Results-Compared with controls, in patients with acute strokes, fibrin clots presented with lower clot permeability, longer lysis time, and higher maximum clot absorbance (for all, PϽ0.001). In ICH patients compared with IS patients, only lysis time was shorter by 13% (PϽ0.001). In the ICH group, neurological deficit correlated significantly (PϽ0.05) with clot compaction, and the rate of increase in D-dimers released from clots, whereas initial hematoma volume correlated with lag phase of fibrin formation on turbidimetry and compaction (PϽ0.05). Conclusions-In both types of acute strokes, fibrin clot properties are altered: denser fibrin clots are relatively resistant to lysis. In acute ICH, fibrin clots are more susceptible to tissue plasminogen activator-mediated lysis compared with in IS, which might affect ICH pathogenesis.

Contraction of Blood Clots Is Impaired in Acute Ischemic Stroke

“…12,18 In stroke patients, fibrin and RBCs can undergo oxidative and proteolytic changes that result in the formation of densely matted deposits of fibrin and RBCs, which have been implicated to play a role in persistent thrombi. 38,39 The abnormal fibrin structure associated with ischemic stroke 40–42 results in lower clot permeability and a slower rate of lysis. 42 …”

Altered Fibrin Clot Properties in Patients With Cerebral Venous Sinus Thrombosis

“…Prothrombotic persistent changes observed after CVST were more pronounced compared with clot abnormalities reported in venous thromboembolism 5 and ischemic stroke. [6][7][8] They cannot be explained by fibrinogen concentrations and demographic/clinical factors. Higher prevalence of thrombophilia in CVST reported also in previous studies 1,2 might, in part, contribute to abnormal clot characteristics.…”

“…Demographic and clinical data were recorded on the day of blood sampling. 5,6,8 Follow-up started at the time of discontinuation of anticoagulant therapy and was carried out on the 6-month basis (a visit at the center or telephone contact). We recorded the objectively documented recurrence of CVST.…”

“…4 Unfavorable fibrin characteristics including faster formation of denser fibrin clots resistant to lysis represent a novel risk factor for both venous thromboembolism 5 and ischemic stroke. [6][7][8] We hypothesized that CVST is also associated with altered fibrin clot phenotype. We investigated plasma fibrin clot characteristics in patients after CVST and their impact on recurrences.…”

Lp(a) is not associated with diabetes but affects fibrinolysis and clot structure ex vivo

“…This may increase the clot mass or influence clot structure and result in an increase in A max . Altered fibrin clot properties represent a novel prothrombotic effect of Lp(a) which is of potential importance in athero-thrombotic vascular disease4344. Lp(a) seems to be one of the factors that contribute to changes in fibrin clot structure which may in vivo affect plaque stability under flow conditions in arteriosclerotic vessels.…”