Ipercoagulabilità e recidiva di infarto cerebrale.

We measured plasma levels of fibrinopeptide A (FPA) and beta-thromboglobulin (BTG) in 27 patients, two months after first stroke. FPA, a sensitive index of "in vivo" hypercoagulability, was significantly higher in stroke patients than in 40 age- and sex-matched controls, and in patients with cerebral infarction who experienced recurrence within 5 years than in those who remained asymptomatic. On the contrary, FPA levels had no prognostic significance among patients with hemorrhagic stroke. Also BTG, an index of platelet activation, was higher in patients than in controls, but it was not associated with stroke recurrence. In a multivariate analysis of hemostatic and clinical variables, only FPA levels greater than 4 ng/ml were significantly related to cerebral reinfarction. These results support the role of hypercoagulability in the recurrence of ischemic stroke and allow identification of patients at high risk of cerebral reinfarction, providing a rationale for clinical trials of anticoagulant therapy in this subgroup.