Features of Platelet Hemostasis in Patients with Ischemic Stroke after Systemic Thrombolytic Therapy

Objective. To study the state of platelet aggregation (PA) in patients with ischemic stroke (II) after systemic thrombolytic therapy (TLT). Materials and methods. A total of 24 patients, 13 with atherothrombotic and 11 with cardioembolic II, receiving systemic TLT were studied. Investigations included assessment of spontaneous and adrenalin-induced PA, the international normalized ratio, the activated partial thromboplastin time, fibrinogen, and the severity of neurological deficit on the NIHSS on days 2, 6–7, 12–14, and 21 after TLT, along with computerized tomography (CT) brain scans before TLT and two days after TLT. Results. A relationship was found between the outcomes of TLT and the characteristics of spontaneous and adrenalin-induced PA. Patients with initially elevated PA (group 1, n = 7) showed the smallest NIHSS scores on day 21. Patients with initially decreased PA (group 2, n = 17) included a subgroup lacking spontaneous aggregation (n = 9) and another with dysregulation of the hemostasis system in the form of increases in spontaneous PA and fibrinogen (n = 8), in whom restoration of neurological functions was less complete than in group 1. Conclusions. The results obtained here can be used for the individual prophylaxis of antiaggregant and anticoagulant treatment after TLT.

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