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Rivista di Angiologia

Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 1998 June;17(2):120-4


lingua: Inglese

The white blood cell and plas­ma fibrino­gen in throm­bot­ic ­stroke. A sig­nif­i­cant cor­re­la­tion

Belch J., McLaren M., Hanslip J., Hill A., Davidson D.

From the University Department of Medicine, Ninewells Hospital & Medical School and Department of Neurology, Dundee Royal Infirmary, Dundee, Scotland


Objectives. Thrombotic ­stroke is a com­mon dis­or­der with con­sid­er­able mor­tal­ity and mor­bid­ity. Risk fac­tors for ­stroke ­include cig­ar­ette smok­ing, hyper­ten­sion and hyper­lip­i­dae­mia and these have been ­linked to abnor­mal­ities of hae­morrh­e­ol­o­gy and coag­u­la­tion such as ­increased fibrino­gen. Other haem­o­rrhe­o­log­i­cal abnor­mal­ities have also been doc­u­ment­ed. These ­include an ele­va­tion in the white blood cell (WBC) count. The aim of our study was to eval­u­ate plas­ma fibrino­gen, WBC aggre­ga­tion and the ­release of free rad­i­cals in throm­bot­ic ­stroke.
Experimental ­design. Thirty-four ­patients with throm­bot­ic ­stroke were ­enrolled in the study. The data were com­pared to 58 ­matched con­trols.
Setting. This study was car­ried out in Ninewells Hospital, Dundee on ­patients pre­vi­ous­ly admit­ted to the med­i­cal wards with acute ­stroke.
Measures. Plasma fibrino­gen, WBC aggre­ga­tion and plas­ma mal­on­dial­de­hyde (MDA) were meas­ured in this study.
Results. As expect­ed, the ­stroke ­patients have a sig­nif­i­cant­ly high­er fibrino­gen level (4.3±1.2 g/dl ver­sus 3.1±0.6, p<0.001). WBC aggre­ga­tion is also ­increased in the ­patient group (47.5±10.4% ver­sus 42.7±10.6, p=0.036), as is plas­ma MDA (8.6±2.0 µmol/l ver­sus 7.1±1.07, p<0.001). The fac­tor VIII von Willebrand fac­tor anti­gen meas­ured as a mark­er as vas­cu­lar dam­age was also sig­nif­i­cant­ly high­er in the ­patient group (251±87% ver­sus 182±64, p<0.001). There was also a sta­tis­ti­cal­ly sig­nif­i­cant cor­re­la­tion ­between fibrino­gen level and WBC aggre­ga­tion, and fibrino­gen and MDA. These are both sta­tis­ti­cal­ly sig­nif­i­cant p=0.012 and p<0.001 respec­tive­ly.
Conclusions. We ­believe our study sug­gests that ­enhanced WBC aggre­ga­tion/adhe­sion with ­release of free rad­i­cals may be ­another mech­a­nism where­by fibrino­gen ­exerts its known det­ri­men­tal ­effect in ­stroke devel­op­ment. This may allow plan­ning of ther­a­peu­tic strat­e­gies as yet unde­vel­oped.

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