Turkish Journal of Geriatrics 2004 , Vol 7, Issue 4
PROTEIN C RESISTANCE AND ACTIVITY IN ELDERLY PATIENTS WITH ACUTE STROKE
Ayşegül ÇAKIR, Şerefnur ÖZTÜRK, Şenay ÖZBAKIR
Ankara Numune Eğitim ve Araştırma Hastanesi 1. Nöroloji Kliniği, ANKARA Hypercoagulability’s place, which is especially inquired in routine in the young patient population, is controversial in the elderly group of the acute stroke patients. In this study, the activity of natural endogen antikoagulan Protein C and the active Protein C resistance’s relationship to the age, characteristics of the lesions, clinical course, prognosis and other risk factors were investigated in adult group of acute ischemic stroke patients. The activity of Protein C and APC resistance was studied in 47 patients (22 female,25 male) which were diagnosed as acute ischemic stroke in the first three days of their stroke. The age average of the patients included in the study was found 66±16. In 10 patients the APC resistance was found to be abnormal according to the normal laboratory values. The Protein C activity was found anormal in 9 patients. When the patients having DM and those who didn’t, were compared according to the haemostatic parameters and Protein C activity, the diabetic patients were found to have statistically meaningful prominent low levels than the non-diabetic group (p=0.038). The prognostical assesment which was made to depend on the first ten days survival showed that the Protein C activity was prominently higher in the patients who survived than the patient who had died (p=0.017). The abnormality in Protein C activity was found in high rates in the patients who died. When the Protein C activity and the other laboratory parameters were inquired, negative corelation was found between the Protein C activity and lasting blood glucose levels, CRP and fibrinogen As a conclusion, Protein C and the other endogen anticoagulans are important with the APC resistance in young stroke patients, but in adult group patient population they interact with inflammatory, metabolic poor prognostic factors. We found that, the decrease in Protein C activation was not correlated to the increase in APC resistance. Our results conclude that the methods that will increase Protein C activation could be important in stroke treatments and may change the prognosis. Keywords : Protein C, Stroke, Factor V Leiden, Elderly.