ORIGINAL RESEARCH
Anesthesiology and Critical Care Medicine
doi: 10.25005/2074-0581-2025-27-1-33-45
EVALUATION OF THE THROMBOGENICITY OF THE VASCULAR ENDOTHELIUM IN PATIENTS IN THE ACUTE PHASE OF THE ISCHEMIC STROKE

E.V. MIKHAYLOV¹, I.N. PASECHNIK², O.P. BARANOVSKAYA³, G.S GRIVKO⁴

1Anesthesiology and Intensive Care Department (Neurointensive Care), Central Clinical Hospital of the Presidential Administration of the Russian Federation, Moscow, Russian Federation
2Anesthesiology and Intensive Care Department, Central State Medical Academy of Administrative Directorate of the President of the Russian Federation, Moscow, Russian Federation
3Clinical Diagnostic Laboratory, Central Clinical Hospital of the Presidential Administration of the Russian Federation, Moscow, Russian Federation
4Orenburg State Medical University, Orenburg, Russian Federation

Objective: To assess the thrombogenicity of the vascular endothelium based on laboratory parameters in patients in the acute phase of the ischemic stroke (IS), depending on the subtype of IS.

Methods: The study involved 51 patients with the first diagnosed IS confirmed by CT/MRI of the brain within 24 hours from the onset of the disease and 20 healthy individuals (control group). D-dimer, von Willebrand factor (vWF) activity, fibrinogen, C-reactive protein (CRP), lipid profile (total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), atherogenic index, triglycerides, very-low-density lipoproteins (VLDL), and the total cholesterol to HDL ratio) were measured to evaluate the thrombogenicity of the vascular endothelium. The clinical course of IS was assessed using the NIHSS, Rivermead, and Rankin scales.

Results: Significant changes in the thrombogenicity of the vascular endothelium were observed in most IS patients, particularly in those with atherothrombotic and cardioembolic subtypes. These changes were assessed through D-dimer levels, vWF activity, and lipid profile parameters, which significantly correlated with age, body mass index (BMI), blood pressure, and clinical severity of neurological damage. The results of factor and regression analysis showed their prognostic significance.

Conclusion: Deviations in the thrombogenicity of the vascular endothelium amidst inflammatory changes in the vessel wall during the acute IS period occur in most patients and have prognostic significance.

Keywords: schemic stroke, vascular endothelium, thrombogenicity, D-dimer, lipid profile, C-reactive protein.

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References
  1. Peplou FV, Martines B, Dambinova SA. Biomarkyory insul'ta [Stroke biomarkers]. Moscow, RF: GEOTAR-Media; 2022. 512 p.
  2. Piradov MA, Maksimova MYu, Tanashyan MM. Insul't: poshagovaya instruktsiya [Stroke: Step-by-step guidelines]. Moscow, RF: GEOTAR-Media; 2020. 288 p.
  3. Suslina ZA, Tanashyan MM, Domashenko MA, Ionova VG, Chechyotkin AO. Disfunktsiya endoteliya pri ishemicheskikh narusheniyakh mozgovogo krovoobrashcheniya [Endothelial dysfunction in patients with ischemic stroke]. Klinicheskaya nevrologiya. 2008;1(2):4 -11.
  4. Gonchar IA, Stepanova YuI, Prudyvus IS. Biohimicheskie prediktory i markyory infarkta golovnogo mozga [Biochemical predictors and brain infarction markers]. Minsk, Belarus: BelMAPO; 2013. 512 p.
  5. Stepanova TV, Ivanov AN, Tereshkina NE, Popykhova EB, Lagutina DD. Markyory endotelial'noy disfunktsii: patogeneticheskaya rol' i diagnosticheskoe znachenie (obzor literatury) [Markers of endothelial dysfunction: Pathogenetic role and diagnostic significance]. Klinicheskaya laboratornaya diagnostika. 2019;64(1):34-41. https://doi.org/10.18821/0869-2084-2019-64-1-34-41
  6. Tanashyan MM, Antonova KV, Spryshkov NE, Panina AA. Metabolicheskie markyory tserebrovaskulyarnoy patologii [Metabolic markers of cerebrovascular pathology]. Terapiya. 2024;5:84-95. https://doi.org/10.18565/therapy.2024.5.84-92
  7. Stakhovskaya LV. Neotlozhnye sostoyaniya v nevrologii [Medical emergencies in neurology]. Moscow, RF: MEDpress-inform; 2021. 240 p.
  8. Alvarez-Perez FJ, Castelo-Branco M, Alvarez-Sabin J. Usefulness of measurement of fibrinogen, D-dimer, D-dimer/fibrinogen ratio, C reactive protein and erythrocyte sedimentation rate to assess the pathophysiology and mechanism of ischaemic stroke. J Neurol Neurosurg Psychiatry. 2011;82(9):986-92. https:// doi.org/10.1136/jnnp.2010.230870
  9. Kawecki C, Lenting PJ, Denis CV. Von Willebrand factor and inflammation. Journal of Thrombosis and Haemostasis. 2017;15(7):1285-94. https//doi. org/10.1111/jth.13696
  10. Malone K, Amu S, Moore AC, Waeber C. Immunomodulatory therapeutic strategies in stroke. Frontiers in Pharmacology. 2019;10:630. https//doi. org/10.3389/fphar.2019.00630
  11. Rayasam A, Hsu M, Kijak JA, Kissel L, Hernandez G, Sandor M, Fabry Z. Immune responses in stroke: How the immune system contributes to damage and healing after stroke and how this knowledge could be translated to better cures? Immunology. 2018;154(3):363-76. https//doi.org/10.1111/imm.12918
  12. Strelnikova MV, Sineglazova AV. Vzaimosvyaz' vospaleniya i okislitel'nogo stressa s tyazhest'yu ostrogo koronarnogo sindroma u muzhchin [Relationship of inflammation and oxidative stress with severity of myocardial injury in acute coronary syndrome in men]. Sovremennye problemy nauki i obrazovaniya. 2020;3. https://doi.org/10.17513/spno.29803
  13. Favate AS, Younger DS. Epidemiology of ischemic stroke. Neurologic Clinics. 2016;34(4):967-80. https://doi.org/10.1016/j.ncl.2016.06.013
  14. Peycheva M, Deneva T, Zahariev Z. The role of fibrinogen in acute ischemic stroke. Neurologia I Neurochirurgia Polska. 2020;55(1):74-80. https://doi. org/10.5603/pjnns.a2020.0094
  15. Levashova OA, Orlova EA, Zolkornyaev IG, Mikulyak NI, Moiseev YaP. Otsenka tsitokinovogo profilya Ts-reaktivnogo belka i urovnya glyukozy krovi u bol'nykh s ishemicheskim insul'tom v ostrom periode zabolevaniya [The assessment of cytokine profile, C-reactive protein and glucose level in patients with ischemic stroke in the acute period of disease]. Meditsinskie nauki. Patologicheskaya fiziologiya. 2020;3:133-43. https://doi.org/10.21685/2072-3032-2020-3-12
  16. Rosario M, Fonseca AC. Update on biomarkers associated with large-artery atherosclerosis stroke. Biomolecules. 2023;13(8):1251. https//doi.org/10.3390/ biom13081251
  17. Chervaev AA, Butskikh MG, Galagudza MM. Mekhanizmy neyrososudistogo sopryazheniya [Mechanisms of neurovascular coupling]. Regionarnoe krovoobrashchenie i mikrotsirkulyatsiya. 2023;2:67-73. https://doi. org/10.24884/1682-6655-2023-22-2-67-73
  18. Maida CD, Norrito RL, Daidone M, Tuttolomondo A, Pinto A. Neuroinflammatory mechanisms in ischemic stroke: Focus on cardioembolic stroke, background, and therapeutic approaches. International Journal of Molecular Sciences. 2020;21:6454. https//doi.org/10.3390/ijms21186454
  19. Chernova EV. Faktor Villebranda [Von Willebrand factor]. Vestnik Severo-Zapadnogo gosudarstvennogo meditsinskogo universiteta im. I.I. Mechnikova. 2018;4(10):73-80. https://doi.org/10.17816/mechnikov201810473-80
  20. Verigo YaI, Demko IV, Petrova MM, Sobko EA, Mamaeva MG. Faktor Villebranda i ego rol' v disfunktsii endoteliya pri ishemicheskoy bolezni serdtsa [Von Willebrand factor and its role in endothelial dysfunction in coronary heart disease]. Sibirskoe meditsinskoe obozrenie. 2014;5:23-8.
  21. Nam KW, Kim CK, Kim TJ, An SJ, Oh K, Mo H, et al. Predictors of 30-day mortality and the risk of recurrent systemic thromboembolism in cancer patients suffering acute ischemic stroke. PLoS One. 2017;12(3):e0172793. https://doi. org/10.1371/journal.pone.0172793
  22. Zhou D, Liu X, Lo K, Huang Y, Feng Y. The effect of total cholesterol/high-density lipoprotein choresterol ratio on mortality risk in the general population. Frontiers in Endocrinology. 2022;13:1012383. https//doi.org/10.3389/fendo.2022.1012383
  23. Amelina IP, Solovyova EYu. Okislitel'nyy stress i vospalenie kak zven'ya odnoy tsepi u bol'nykh s khronicheskimi tserebrovaskulyarnymi zabolevaniyami [Oxidative stress and inflammation as links in a chain in patients with chronic cerebrovascular diseases]. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2019;119(4):106-14. https://doi.org/10.17116/jnevro2019119041106

Authors' information:

Mikhaylov Evgeniy Viktorovich,
Head of Anesthesiology and Intensive Care Department (Neurointensive Care), Central Clinical Hospital of the Presidential Administration of the Russian Federation
Researcher ID: LJK-4348-2024
ORCID ID: 0009-0001-6696-9020
E-mail: evvvmix@mail.ru

Pasechnik Igor Nikolaevich,
Doctor of Medical Sciences, Full Professor, Head of Anesthesiology and Intensive Care Department, Central State Medical Academy of Administrative Directorate of the President of the Russian Federation
Researcher ID: K-3814-2015
Scopus ID: 7004439316
ORCID ID: 0000-0002-8121-4160
SPIN: 4433-1418
Author ID: 93463
E-mail: pasigor@yandex.ru

Baranovskaya Oksana Petrovna,
Candidate of Biological Sciences, Head of Clinical Diagnostic Laboratory, Central Clinical Hospital of the Presidential Administration of the Russian Federation
ORCID ID: 0009-0007-0731-9195
E-mail: mimibop@mail.ru

Grivko Gleb Sergeevich,
Student of the Faculty of «General Medicine», Orenburg State Medical University
ORCID ID: 0009-0003-3094-1936
E-mail: glebbgriffko@mail.ru

Information about support in the form of grants, equipment, medications

The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

Mikhaylov Evgeniy Viktorovich
Head of Anesthesiology and Intensive Care Department (Neurointensive Care), Central Clinical Hospital of the Presidential Administration of the Russian Federation

121359, Russian Federation, Moscow, Marshal Timoshenko str., 15

Tel.: +7 (917) 5042486

E-mail: evvvmix@mail.ru


This work is licensed under a Creative Commons Attribution 4.0 International License.

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