Abstract WMP118: Thrombin generation is associated with outcome in patients with stroke treated with thrombolysis
Bibliographic record
Abstract
Background and Purpose: Thrombolysis can improve outcome in patients with acute ischemic stroke. However, recanalization is not always complete with persisting cerebral vascular occlusion in >50% of patients despite treatment. Properties of the formed thrombus may influence thrombolysis efficiency and impede recanalization success. Here we examine whether differences thrombin generation are associated with unfavourable outcome in thrombolysis treated patients with acute ischemic stroke. Methods: Two cohorts of patients with acute ischemic stroke treated with thrombolysis were recruited (cohort 1 n=36 patients, cohort 2 n= 42). Thrombin generation was determined by thrombin generation assay and related to stroke outcome at 90-days determined by modified Rankin Scale (mRS). The relationship of thrombin concentration to clot lysis rate was examined in vitro. Inflammatory factors associated with increased thrombin generation were also identified. Results: An increase in peak thrombin was associated with unfavourable 90-day outcome in patients with acute ischemic stroke treated with thrombolysis. In cohort 1, patients with mRS£2 had a mean peak thrombin of 208.4nM compared to 255.5nM in those with mRS>2 (p=0.019). In cohort 2, patients with mRS£2 had a mean peak thrombin of 211.1nM compared to 251.6nM in those with mRS>2 (p=0.019). In vitro , an increase in thrombin concentration slowed the rate of clot lysis by tPA. In patients with stroke, an increase in peak thrombin was associated with increased plasma interleukin (IL)-6, interleukin-8 and a decrease in a2-macroglobulin. In vitro , IL-6 can was found to increase thrombin generation via monocyte tissue factor. Conclusions: Increased thrombin generation on admission is associated with unfavourable outcome at 90 days in thrombolysis treated stroke patients. Higher thrombin generation may influence thrombus properties, reducing effectiveness of thrombolysis, and impairing recanalization. Further understanding regarding the relationship of thrombin generation to thrombolysis is necessary to enhance recanalization and further improve outcomes in stroke.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".