Indicators of homeostasis, inflammation and homocysteine in ischemic stroke in the young age L.A. DOBRYNINA, L.A. KALASHNIKOVA, A.A. SHABALINA, M.V. KOSTYREVA, E.V. ALEKSANDROVA, M.E. GAFAROVA,
K.V. SHAMTIEVA
Neurology Research Center, Moscow, Russia
Objective. To determine indicators of homeostasis, inflammation and homocysteine in the young-aged patients with ischemic
stroke (IS) of different genesis in the subacute and chronic stages.
Material and methods. Out of 218 patients with IS (mean age
34.7±8.7 years), 55 had stroke due to dissection of the inner carotid or the spinal artery, 28 due to cardioembolia, 38 due to
antiphospholipid syndrome (APS), 16 due to cerebral arteritis; 85 patients were classified as having cryptogenic stroke, including
23 with noncerebral thrombosis (coagulopathy of unknown etiology) and 62 with no thrombosis. The control group included 28
healthy people matched for age and sex.
Results. There were 1) an increase in von Willebrand factor and coagulation factor VIII
as well as a decrease in plasminogen and an increase in plasmin-inhibitor in IS caused by thrombosis (APS, cardioembolia,
coagulopathy of unknown etiology); 2) alterations in erythrocyte aggregation and deformity in cryptogenic stroke; 3) mild or
moderate hyperhomocysteinemia, with the exception of patients with APS and arteritis. Linear regression analysis confirmed these
relationships. Discriminant analysis identified the clusters of parameters characteristic of APS (an increase in (aPTT), plasminogen,
blood sedimentation rate, C-reactive protein) and cardioembolia (decreased protein C and increased hematocrit).
Conclusion. The
laboratory markers associated with cerebral thrombosis can be used for identification of a prothrombotic state as a cause of IS in
the young age. Moderate hyperhomocysteinemia is a risk factor but not a cause of IS. The increase of inflammatory markers in APS
suggests a role of infection in its development.
