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dc.contributor.authorLillicrap, T
dc.contributor.authorKeragala, CB
dc.contributor.authorDraxler, DF
dc.contributor.authorChan, J
dc.contributor.authorHo, H
dc.contributor.authorHarman, S
dc.contributor.authorNiego, B
dc.contributor.authorHolliday, E
dc.contributor.authorLevi, CR
dc.contributor.authorGarcia-Esperon, C
dc.contributor.authorSpratt, N
dc.contributor.authorGyawali, P
dc.contributor.authorBivard, A
dc.contributor.authorParsons, MW
dc.contributor.authorMontaner, J
dc.contributor.authorBustamante, A
dc.contributor.authorCadenas, IF
dc.contributor.authorCloud, G
dc.contributor.authorMaguire, JM
dc.contributor.authorLincz, L
dc.contributor.authorKleinig, T
dc.contributor.authorAttia, J
dc.contributor.authorKoblar, S
dc.contributor.authorHamilton-Bruce, MA
dc.contributor.authorChoi, P
dc.contributor.authorWorrall, BB
dc.contributor.authorMedcalf, RL
dc.date.accessioned2020-12-09T22:44:23Z
dc.date.available2020-12-09T22:44:23Z
dc.date.issued2020-11-03
dc.identifier.citationLillicrap, T., Keragala, C. B., Draxler, D. F., Chan, J., Ho, H., Harman, S., Niego, B., Holliday, E., Levi, C. R., Garcia-Esperon, C., Spratt, N., Gyawali, P., Bivard, A., Parsons, M. W., Montaner, J., Bustamante, A., Cadenas, I. F., Cloud, G., Maguire, J. M. ,... Medcalf, R. L. (2020). Plasmin Generation Potential and Recanalization in Acute Ischaemic Stroke; an Observational Cohort Study of Stroke Biobank Samples. FRONTIERS IN NEUROLOGY, 11, https://doi.org/10.3389/fneur.2020.589628.
dc.identifier.issn1664-2295
dc.identifier.urihttp://hdl.handle.net/11343/253059
dc.description.abstractRationale: More than half of patients who receive thrombolysis for acute ischaemic stroke fail to recanalize. Elucidating biological factors which predict recanalization could identify therapeutic targets for increasing thrombolysis success. Hypothesis: We hypothesize that individual patient plasmin potential, as measured by in vitro response to recombinant tissue-type plasminogen activator (rt-PA), is a biomarker of rt-PA response, and that patients with greater plasmin response are more likely to recanalize early. Methods: This study will use historical samples from the Barcelona Stroke Thrombolysis Biobank, comprised of 350 pre-thrombolysis plasma samples from ischaemic stroke patients who received serial transcranial-Doppler (TCD) measurements before and after thrombolysis. The plasmin potential of each patient will be measured using the level of plasmin-antiplasmin complex (PAP) generated after in-vitro addition of rt-PA. Levels of antiplasmin, plasminogen, t-PA activity, and PAI-1 activity will also be determined. Association between plasmin potential variables and time to recanalization [assessed on serial TCD using the thrombolysis in brain ischemia (TIBI) score] will be assessed using Cox proportional hazards models, adjusted for potential confounders. Outcomes: The primary outcome will be time to recanalization detected by TCD (defined as TIBI ≥4). Secondary outcomes will be recanalization within 6-h and recanalization and/or haemorrhagic transformation at 24-h. This analysis will utilize an expanded cohort including ~120 patients from the Targeting Optimal Thrombolysis Outcomes (TOTO) study. Discussion: If association between proteolytic response to rt-PA and recanalization is confirmed, future clinical treatment may customize thrombolytic therapy to maximize outcomes and minimize adverse effects for individual patients.
dc.languageEnglish
dc.publisherFRONTIERS MEDIA SA
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.titlePlasmin Generation Potential and Recanalization in Acute Ischaemic Stroke; an Observational Cohort Study of Stroke Biobank Samples
dc.typeJournal Article
dc.identifier.doi10.3389/fneur.2020.589628
melbourne.affiliation.departmentMedicine (RMH)
melbourne.affiliation.facultyMedicine, Dentistry & Health Sciences
melbourne.source.titleFrontiers in Neurology
melbourne.source.volume11
dc.rights.licenseCC BY
melbourne.elementsid1482577
melbourne.contributor.authorBivard, Andrew
melbourne.contributor.authorParsons, Mark
dc.identifier.eissn1664-2295
melbourne.accessrightsOpen Access


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