Protein C and factor X activities from patients with ischemic stroke and type II diabetes mellitus.

O. Kravchenko, O. Savchuk, T. Tsarenko, L. Ostapchenko (Kiev, Ukraine)

Arterial thrombosis
Date: 17.02.2017,
Time: 17:15 - 18:15

Objective: Similar to blood coagulation factors II (protrombin) and X, the protein C synthesis in the liver depends on the presence of vitamin K. However, in contrast to the other coagulation factors, protein C, when activated by thrombin, is not a procoagulant but a potent anticoagulant. Abnormalities in the plasmatic coagulation system have been repeatedly described in patients with diabetes mellitus (DM) and have been linked to variety vascular diseases, including atherosclerosis and ischemic stroke (IS), which have been associated with hemostasis disorders too. So the aim of the present study were to determine the activities of protein C (PC), factor X and protrombin content in patient under ischemic stroke and stroke complicated by type II diabetes mellitus.

Methods: Coagulation studies were performed on 67 patients shortly after their admission to the hospital. These persons were selected by tomography and magnetic resonance imaging confirmed of IS. The 24 from them had type II diabetes mellitus, which was established by laboratory tests. The activities of protein C (PC) and factor X were analyzed using specific chromogenic substrates. Protrombin content was determined by Elisa. Statistical analysis of the data was performed by computerized analysis.

Results: The protein C activity was found to be significantly decreased in the both total groups of IS and IS with diabetic patients compared with the controls. The estimated reduction of PC activity was more marked in case of IS alone. Thus the plasma protrombin contents were increased on 18% from the control for the both investigated groups of patient. The plasma coagulation factor X activity was increased only under IS and accounting for 117% of the controls.

Conclusion: Because the levels of coagulation factor II and factor X activities were not reduced neither in ischemic stroke patients nor IS with diabetic patients, the reduction of protein C seems to be caused not by reduced its synthesis in the liver, but more likely by an increased clearance from the blood plasma. The decrease of protein C activity accompanied by increase of factor X activity with high protormbin content in the plasma of ischemic stroke and type II diabetic patients indicates an abnormal, probably hypercoagulable conditions in aforementioned disorders.