The benefits of thrombolytic therapy in a patient with diabetes having a myocardial infarction are now well accepted but this treatment may be withheld inappropriately because of concerns about retinal haemorrhage. We therefore examined whether junior doctors alter their use of thrombolysis for the
Fibrinolytic measurements in Type 2 diabetic patients with acute cerebral infarction
β Scribed by Mansfield, M.W.; Catto, A.J.; Carter, A.M.; Grant, P.J.
- Publisher
- John Wiley and Sons
- Year
- 1998
- Tongue
- English
- Weight
- 92 KB
- Volume
- 15
- Category
- Article
- ISSN
- 0742-3071
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β¦ Synopsis
The aim of this study was to investigate disturbances in fibrinolytic components in Type 2 diabetes patients with acute ischaemic stroke. Levels of plasminogen activator inhibitor-1 (PAI-1) activity and tissue PA (t-PA) antigen were measured in Type 2 diabetes subjects with (n=40) and without (n=80) acute stroke compared to non-diabetic subjects with (n=80) and without (n=80) acute ischaemic stroke. Diabetes was defined by WHO criteria and absence of diabetes by blood glucose Ο½7.8 mmol -1 and HbA IC Ο½6 % (reference range for assay 4.5-6.5 %). Levels of t-PA antigen were lower in healthy controls (9.2 ng ml -1 ) than in either stroke group (non-diabetic stroke patient: 12.6 ng ml -1 ; diabetic patient with stroke: 13.5 ng ml -1 (each at pΟ½0.05)) and intermediate in diabetic patients without stroke (11.1 ng ml -1 , ns). In a regression model levels of t-PA were related to stroke, BMI and age but not to diabetes or sex. Diabetic subjects without stroke had higher PAI-1 activity levels than either non-diabetic group (17.7 Uml -1 vs 12.1 U ml -1 and 9.2 U ml -1 (each at pΟ½0.05)). Levels were intermediate in diabetic subjects with stroke (12.8 U ml -1 , ns). In a regression model levels of PAI-1 were related to Type 2 diabetes, female sex, and body mass index but not stroke or age. These data suggest that further suppression of fibrinolysis does not occur with ischaemic stroke in Type 2 diabetes. The findings contrast with the importance of impaired fibrinolysis in coronary artery disease previously reported in both Type 2 diabetic patients and non-diabetic subjects.
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