Plasma tPA-Activity and Progression of Cerebral White Matter Hyperintensities in Lacunar Stroke Patients |
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| Authors: | Ellen C. van Overbeek Julie Staals Iris L. H. Knottnerus Hugo ten Cate Robert J. van Oostenbrugge |
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| Affiliation: | 1. Department of Neurology, Maastricht University Medical Centre (MUMC), Maastricht, the Netherlands;2. Cardiovascular Research Institute Maastricht, MUMC, Maastricht, the Netherlands;3. Department of Neurology, Medisch Spectrum Twente, Enschede, the Netherlands;4. Department of Internal Medicine, MUMC, Maastricht, the Netherlands;University of Rouen, France, FRANCE |
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| Abstract: | IntroductionTissue plasminogen activator (tPA)-activity and plasminogen activator inhibitor type 1 (PAI-1) antigen are considered to be haemostasis-related markers of endothelial activation and relate to presence of cerebral white matter hyperintensities (WMH) as was earlier shown in a cross-sectional study. We investigated whether tPA-activity and PAI-1 levels are associated with WMH progression in a longitudinal study.MethodsIn 127 first-ever lacunar stroke patients in whom baseline brain MRI and plasma levels of tPA-activity and PAI-1-antigen were available, we obtained a 2-year follow-up MRI. We assessed WMH progression by a visual WMH change scale. We determined the relationship between levels of tPA-activity and PAI-1 and WMH progression, by logistic regression analysis.ResultsPlasma tPA-activity was associated with periventricular WMH progression (OR 2.36, 95% CI 1.01–5.49, with correction for age and sex and baseline presence of WMH), but not with deep or any (periventricular and/or deep) WMH progression. PAI-1 levels were lower in patients with WMH progression, but these results were not significant.ConclusionWe found a relationship between plasma tPA-activity and progression of periventricular WMH. More research is needed to determine whether there is a (direct) role of tPA in the development and progression of WMH. |
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