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Review
. 2019 Jun;129(6):612-618.
doi: 10.1080/00207454.2018.1550400. Epub 2018 Dec 27.

Not all clots are created equal: a review of deficient thrombolysis with tissue plasminogen activator (tPA) in patients with metabolic syndrome

Charles I Mosimah  1 , Pamela J Murray  2 , James W Simpkins  3
Affiliations
Review

Not all clots are created equal: a review of deficient thrombolysis with tissue plasminogen activator (tPA) in patients with metabolic syndrome

Charles I Mosimah et al. Int J Neurosci. 2019 Jun.

Abstract

Metabolic syndrome is a cluster of cardiovascular risk factors associated with a prothrombotic, proinflammatory and hypofibrinolysis state. Although resistance to tissue plasminogen activator (tPA) in metabolic syndrome patients has been associated with a defective fibrinolytic system, the factors and mechanisms underlining such resistance is unclear. While there is a great debate on proposed mechanisms, fundamental questions regarding resistance to tPA in metabolic syndrome patients with ischemic stroke remain unanswered. This article reviews articles and documents published between 2001 and 2017, and provides an overview of metabolic syndrome, factors associated with tPA resistance in metabolic syndrome, conflicting evidence of insufficient dosing of tPA in overweight/obese patients and future directions for research.

Keywords: Metabolic syndrome; cardiovascular disease; ischemic stroke; thrombolysis; tissue plasminogen activator.

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No potential conflict of interest was reported by the authors.

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References

    1. Benjamin EJ, Blaha MJ, Chiuve SE, et al. Heart disease and stroke statistics-2017 update: a report from the American Heart Association. Circulation 2017;135: e146–e603. - PMC - PubMed
    1. Lucke-Wold BP, DiPasquale K, Logsdon AF, et al. Metabolic syndrome and its profound effect on prevalence of ischemic stroke. Am Med Stud Res J. 2014;1:29–38. - PMC - PubMed
    1. Boden-Albala B, Sacco RL, Lee H-S, et al. Metabolic syndrome and ischemic stroke risk: Northern Manhattan study. Stroke 2008;39:30–35. - PMC - PubMed
    1. Zhu Z, Fu Y, Tian D, et al. Combination of the immune modulator fingolimod with alteplase in acute ischemic stroke: a pilot trial. Circulation 2015;132: 1104–1112. - PMC - PubMed
    1. Anand SS, Yi Q, Gerstein H, et al. Relationship of metabolic syndrome and fibrinolytic dysfunction to cardiovascular disease. Circulation 2003;108: 420–425. - PubMed

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