Pathogenetic mechanisms of development of ischemic stroke and effects of major factors on the prognosis of disease

Abstract

Aim. To study pathogenetic mechanisms of the development of ischemic stroke and the effect of major factors on the prognosis of disease.

Materials and methods. The study included 160 people. 100 of them (50 men and 50 women aged 18 to 40) were healthy (had no complaints, no records in a specialized clinic, and no documented disease) and volunteered to participate the study. Ischemic stroke was diagnosed in 60 participants (30 men and 30 women). Indexes of red blood, blood rheology, concentrations of endothelin, von Willebrand factor, tPA-PAI-1, and AT III complexes, procoagulant mechanisms of hemostasis and fibrinogen system, aggregation activities of platelets, white blood, cellular and humoral immunity, indexes of complement system activity, and cytokine concentrations were studied in relatively healthy people with endothelial dysfunction taking into account gender differences.

Results. We recommended considering serum LP and TIMP-1, MMPs – 2, 7, and 9, AT III, vWF, and tPA-PAI-1, indexes coagulation hemostasis, blood viscosity at all shear rates, as well as the amount of pro- and anti-inflammatory cytokines as predictors of an unfavorable outcome in ischemic stroke. It is important that the totality of these indexes has a predictive significance rather than their individual values. If these indexes do not recover at 6-8 days after the start of treatment then these changes should be considered as an unfavorable factor for a patient with ischemic stroke that contributes to the development of complications or death.