Chen, Y, Gue, Y, McDowell, G, Gorog, DA and Lip, GYH (2024) Impaired endogenous fibrinolysis status: a potential prognostic predictor in ischemic stroke. Minerva Medica, 115 (3). pp. 364-379. ISSN 0026-4806

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Abstract

Stroke confers a severe global healthcare burden, hence exploring risk factors for stroke occurrence and prognosis is important for stroke prevention and post-stroke management strategies. Endogenous fibrinolysis is a spontaneous physiological protective mechanism that dissolves thrombus to maintain vascular patency. Recently, impaired endogenous fibrinolysis has been considered as a potential novel cardiovascular risk factor, but its link with ischaemic stroke in the past has been underappreciated. In this review, we summarize the latest mechanisms of endogenous fibrinolysis, review the current evidence and data on endogenous fibrinolysis in ischemic stroke. It includes the structure of thrombus in ischemic stroke patients, the effect of fibrin structure on the endogenous fibrinolytic efficiency, and the association between intravenous thrombolytic therapy and endogenous fibrinolysis in ischemic stroke. It also includes the single factors (tissue plasminogen activator, urokinase plasminogen activator, plasminogen activator inhibitor-1, thrombin activatable fibrinolysis inhibitor, complement component 3, complement component 5, alpha-2-antiplasmin, plasmin-alpha-2-anti-plasmin complex, and lipoprotein[a]), and the global assessments of endogenous fibrinolysis status (thromboelastography, rotational thromboelastometry, and global thrombosis test), and their potential as predictors to identify occurrence or unfavorable functional outcomes of ischemic stroke. All of these assessments present advantages and limitations, and we suggest that the global thrombosis test may be more appropriate for detecting impaired endogenous fibrinolysis status in ischemic stroke patients.

Item Type:	Article
Uncontrolled Keywords:	Humans; Thrombosis; Prognosis; Thrombolytic Therapy; Fibrinolysis; Ischemic Stroke; Humans; Fibrinolysis; Ischemic Stroke; Prognosis; Thrombolytic Therapy; Thrombosis; General & Internal Medicine
Subjects:	Q Science > QH Natural history > QH301 Biology
Divisions:	Pharmacy & Biomolecular Sciences
Publisher:	Edizioni Minerva Medica
SWORD Depositor:	A Symplectic
Date Deposited:	24 Sep 2024 11:36
Last Modified:	24 Sep 2024 11:36
DOI or ID number:	10.23736/S0026-4806.24.09133-X
URI:	https://researchonline.ljmu.ac.uk/id/eprint/24249

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