Low factor XIII levels after intravenous thrombolysis predict short-term mortality in ischemic stroke patients

Edina Gabriella Székely, Katalin Réka Czuriga-Kovács, Z. Bereczky, E. Katona, Zoltán András Mezei, Attila Nagy, Noémi Klára Tóth, Ervin Berényi, L. Muszbek, L. Csiba, Z. Bagoly

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Abstract

In this observational study we investigated whether levels of factor XIII (FXIII) and its major polymorphisms affect the outcome of thrombolysis by recombinant tissue plasminogen activator (rtPA) in acute ischemic stroke (AIS) patients. Study cohort included 132 consecutive AIS patients undergoing i.v. thrombolysis within 4.5 h of symptom onset. Blood samples taken on admission, immediately after and 24 h after therapy were analyzed for FXIII activity and antigen levels. FXIII-A p.Val34Leu, p.Tyr204Phe, FXIII-B p.His95Arg and intron K(IVS11 + 144) polymorphisms were genotyped. Neurological deficit was assessed using the National Institutes of Health Stroke Scale. Intracranial hemorrhage was classified according to ECASSII criteria. Long-term functional outcome was defined at 3 months post-event by the modified Rankin scale. FXIII levels showed a gradual decrease immediately after thrombolysis and 24 h later, which was not related to therapy-associated bleeding. In a multiple logistic regression model, a FXIII level in the lowest quartile 24 h post-lysis proved to be an independent predictor of mortality by 14 days post-event (OR:4.95, 95% CI:1.31-18.68, p < 0.05). No association was found between the investigated FXIII polymorphisms and therapeutic outcomes. In conclusion, our findings indicate that FXIII levels 24 h after thrombolysis might help to identify patients at increased risk for short-term mortality.

Original languageEnglish
Article number7662
JournalScientific Reports
Volume8
Issue number1
DOIs
Publication statusPublished - Dec 1 2018

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Factor XIII
Stroke
Mortality
Logistic Models
Intracranial Hemorrhages
National Institutes of Health (U.S.)
Tissue Plasminogen Activator
Introns
Observational Studies
Cohort Studies
Therapeutics
Hemorrhage
Antigens

ASJC Scopus subject areas

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Low factor XIII levels after intravenous thrombolysis predict short-term mortality in ischemic stroke patients. / Székely, Edina Gabriella; Czuriga-Kovács, Katalin Réka; Bereczky, Z.; Katona, E.; Mezei, Zoltán András; Nagy, Attila; Tóth, Noémi Klára; Berényi, Ervin; Muszbek, L.; Csiba, L.; Bagoly, Z.

In: Scientific Reports, Vol. 8, No. 1, 7662, 01.12.2018.

Research output: Contribution to journalArticle

Székely, Edina Gabriella ; Czuriga-Kovács, Katalin Réka ; Bereczky, Z. ; Katona, E. ; Mezei, Zoltán András ; Nagy, Attila ; Tóth, Noémi Klára ; Berényi, Ervin ; Muszbek, L. ; Csiba, L. ; Bagoly, Z. / Low factor XIII levels after intravenous thrombolysis predict short-term mortality in ischemic stroke patients. In: Scientific Reports. 2018 ; Vol. 8, No. 1.
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abstract = "In this observational study we investigated whether levels of factor XIII (FXIII) and its major polymorphisms affect the outcome of thrombolysis by recombinant tissue plasminogen activator (rtPA) in acute ischemic stroke (AIS) patients. Study cohort included 132 consecutive AIS patients undergoing i.v. thrombolysis within 4.5 h of symptom onset. Blood samples taken on admission, immediately after and 24 h after therapy were analyzed for FXIII activity and antigen levels. FXIII-A p.Val34Leu, p.Tyr204Phe, FXIII-B p.His95Arg and intron K(IVS11 + 144) polymorphisms were genotyped. Neurological deficit was assessed using the National Institutes of Health Stroke Scale. Intracranial hemorrhage was classified according to ECASSII criteria. Long-term functional outcome was defined at 3 months post-event by the modified Rankin scale. FXIII levels showed a gradual decrease immediately after thrombolysis and 24 h later, which was not related to therapy-associated bleeding. In a multiple logistic regression model, a FXIII level in the lowest quartile 24 h post-lysis proved to be an independent predictor of mortality by 14 days post-event (OR:4.95, 95{\%} CI:1.31-18.68, p < 0.05). No association was found between the investigated FXIII polymorphisms and therapeutic outcomes. In conclusion, our findings indicate that FXIII levels 24 h after thrombolysis might help to identify patients at increased risk for short-term mortality.",
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