Using thrombin time to evaluate the efficacy of anticoagulant therapy for acute cerebral infarction

Background Although intravenous thrombolysis therapy has been considered as a significant progress in the treatment of acute ischemic stroke, there are limited effective treatments for patients with onset ischemic symptom that beyond six hours during acute ischemic stroke. In this study, we investigated the effectiveness of the intravenous argatroban therapy in acute ischemic stroke patients who cannot be treated with intravenous thrombolysis due to the limited time window. Methods One hundred and eighty patients with acute ischemic stroke that had beyond six hours ischemic symptom were admitted to our hospital and were analyzed retrospectively. Levels of activated partial thromboplastin time (aPTT), prothrombin time (PT) and thrombin time (TT) in peripheral blood of these patients were measured by ELISA at 24 hours post initial therapy. Results We found that plasma TT was significantly prolonged after 24 hours of argatroban treatment. aPTT showed slightly increased prolongation after 24 hours of argatroban treatment. PT also showed slightly prolonged after treatment, however, there was no difference from the basal line. We further investigated the relationship between the level of TT and the clinical effectiveness and safety of intravenous argatroban therapy. We found that when TT was between 40 and 80 seconds, intravenous argatroban effectively promoted the complete recovery rates without increasing the risk of hemorrhage. Conclusion Our study implies that TT assay might be useful for guiding regular dose of agratroban for therapy.