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From the Neurological Clinic II (Drs. Landi, Candelise, and Nobile Orazio), Ospedale Maggiore and University of Milano; A. Bianchi Bonomi Hemophilia and Thrombosis Center and Institute of Internal Medicine (Drs. D'Angelo and Mannucci), University of Milano; the Department of Neuroradiology (Dr. Boccardi), Ospedale Niguarda, and the Institute of Medical Statistics and Biometry (Dr. Morabito), University of Milano, Milano, Italy.
To evaluate the clinical significance of hemostatic abnormalities in acute stroke, we studied coagulation and platelet function in 70 patients with recent cerebral infarction or hemorrhage and in 45 age-matched controls. Higher levels of one-stage factor VIII coagulant activity, fibrinopeptide A (FPA), and beta-thromboglobulin were associated with the occurrence of stroke. All hemostatic test results were remarkably similar in patients with ischemic and hemorrhagic stroke. FPA levels and size of the lesion on CT were the only variables independently predicting mortality in a multivariate regression analysis. Our findings demonstrate that hypercoagulability is an important prognostic factor in stroke and lend support to clinical trials of drugs interfering with the coagulation system in the early phase of cerebral ischemia.
Address correspondence and reprint requests to Dr. Landi, Università di Milano, Istituto di Clinica Neurologica, 35 Via Francesco Sforza, 20122 Milano, Italy.
Received October 15, 1986. Accepted for publication in final form December 31, 1986.
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