Abstract Details

Title Enhanced Thrombin Generation Potential in Recently Symptomatic Versus Asymptomatic Moderate and Severe Carotid Artery Stenosis - Results from the Platelets and Carotid Stenosis (PACS) Study

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P03 - (-)

Poster/Presentation
Number 154

Objective

Background BACKGROUND: The importance of thrombin generation in the pathogenesis of TIA or stroke in patients with asymptomatic and symptomatic carotid stenosis is unclear.

Design/Methods DESIGN/METHODS: Thrombin generation parameters from patients with moderate or severe (?50%) asymptomatic carotid stenosis were compared with those from symptomatic carotid stenosis patients in the early (?4 weeks) and late phases (?3 months) after TIA or stroke in a multicentre, prospective observational study. We assessed the longitudinal thrombin generation profile in symptomatic patients with data in both the early and late phases after symptom onset. The following thrombin generation parameters were quantified in platelet-poor plasma: 'lag time' to initial thrombin generation, 'peak thrombin', 'time-to-peak thrombin', 'start-tail time' to end of thrombin generation, and endogenous thrombin potential (ETP).

Results RESULTS: Data from 31 asymptomatic, 46 early phase symptomatic, and 35 late phase symptomatic patients (23 of whom had undergone carotid intervention) were analysed. Peak thrombin (344.2 vs. 305.3nM; p=0.01) and ETP (1772.4 vs. 1589.7; p=0.047 were higher in early symptomatic than asymptomatic patients. Peak thrombin (338.3 vs. 299.5nM; p=0.02) and ETP (1708.4 vs. 1528.6 nM x min; p=0.04) were elevated in early severe symptomatic vs. severe asymptomatic carotid stenosis. Peak thrombin production decreased in symptomatic patients followed up from the early to late phase after symptom onset (339.7 vs. 308.6nM; p=0.02).

Conclusions CONCLUSIONS: Patients with recently symptomatic moderate or severe carotid stenosis have increased thrombin generation potential compared with their asymptomatic counterparts. Thrombin generation potential decreases over time following TIA or stroke associated with extracranial carotid stenosis. Further longitudinal studies are warranted to assess the prognostic value of haemostatic/thrombotic biomarkers at predicting the risk of stroke recurrence in asymptomatic and symptomatic carotid stenosis.

Authors/Disclosures
Justin Kinsella, MD (St.Vincent's University Hospital) PRESENTER	Dr. Kinsella has nothing to disclose.
W. O. Tobin, PhD, MBBCh, BAO, FAAN (Mayo Clinic)	Dr. Tobin has received publishing royalties from a publication relating to health care.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Gary R. Cutter, PhD (University of Alabama At Birmingham)	Dr. Cutter has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for onsulting or Advisory Boards: Alexion, Antisense Therapeutics/Percheron, Avotres, Biogen, Clene Nanomedicine, Clinical Trial Solutions LLC, Endra Life Sciences, Cognito Therapeutics, Genzyme, Genentech, Immunic, Klein-Buendel Incorporated, Kyverna Therapeutics, Inc. , Linical, Merck/Serono, Noema, Neurogenesis, Perception Neurosciences, Protalix Biotherapeutics, Regeneron, Revelstone Consulting, Roche, SAB Biotherapeutics, Sapience Therapeutics, Scott&Scott LLP, Tenmile.. Dr. Cutter has received personal compensation in the range of $50,000-$99,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Data and Safety Monitoring Boards: Applied Therapeutics, AI therapeutics, AMO Pharma, Argenx, Astra-Zeneca, Avexis Pharmaceuticals, Bristol Meyers Squibb, CSL Behring, Cynata Therapeutics, DiamedicaTherapeutics, Horizon Pharmaceuticals, Immunic, Inhibrix, Karuna Therapeutics, Kezar Life Sciences, Medtronic, Merck, Meiji Seika Pharma, Mitsubishi Tanabe Pharma Holdings, Prothena Biosciences, Novartis, Pipeline Therapeutics (Contineum), Regeneron, Sanofi-Aventis, Teva Pharmaceuticals, United BioSource LLC, University of Texas Southwestern.. Dr. Cutter has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JASN.
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Colin Doherty, MD	The institution of Dr. Doherty has received research support from UCB pharma. The institution of Dr. Doherty has received research support from Science foundation Ireland.
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Raymond P. Murphy, FRCP	No disclosure on file
	No disclosure on file
Dominick J. McCabe, MD, PhD	No disclosure on file

��ɫ��

��ɫ��