Evaluation of Vascular Endothelial Growth Factor A and Selected Parameters of Coagulation and Fibrinolysis in a Group of Patients with Subarachnoid Haemorrhage

Abstract

Introduction. Subarachnoid hemorrhage (SAH) is currently one of the most serious diseases of the central nervous system. To reduce the negative consequences of SAH and help clinicians to assess the patient’s condition, there are attempts to search for new diagnostic markers, which quickly and accurately allow for the proper diagnosis. The aim of this research was the concentration and activity of Vascular Endothelial Growth Factor A (VEGF-A) and selected parameters of coagulation and fibrinolysis in the blood of patients with SAH. Serum levels of VEGF-A in patients diagnosed with SAH are measured to assess the correlation between VEGF-A and the clinical condition of patient. This may help with proper therapeutics and better prognosis. Methods. The study involved 85 patients with subarachnoid hemorrhage. The control group consisted of 45 healthy subjects, sex and age matched. The following parameters were determined: APTT (Activated Partial Thromboplastin Time), INR (International Normalized Ratio), D-dimers and fibrinogen concentration, and the concentration of VEGF-A by ELISA (R&D USA). Results. The average concentration of VEGF-A in the study group was significantly lower compared to the control group. The D-dimer concentration was higher in patients with SAH but the difference was not significant. Coagulation parameters such as INR, APTT, and fibrinogen did not show significant differences between investigated groups. Conclusions. VEGF-A cannot be an independent marker of SAH. Selected parameters of coagulation and fibrinolysis such as D-dimers, INR, APTT, and fibrinogen should not be used as markers of SAH.

Hemostasis and Fibrinolysis following Aneurysmal Subarachnoid Hemorrhage: A Systematic Review on Additional Knowledge from Dynamic Assays and Potential Treatment Targets

“…Prothrombin time (PT), international normalized ratio (INR), and activated partial thromboplastin time (aPTT) were all consequently within reference ranges. 35 37 42 49 50 51 53 65 66 When comparing with healthy control groups, a few studies found that aPTT tended to be shortened 37 39 and INR slightly prolonged, 37 but still within reference ranges.…”

“…32 36 39 40 41 42 43 44 In accordance with this, fibrin degradation products (FDPs) were also increased in the studies by Ebihara et al, Sasaki et al, and Tsementzis et al 40 43 62 Only two studies found a mean D-dimer within reference range. 35 57…”

“…The studies are divided into studies focusing on primary hemostasis (n ¼ 5) [27][28][29][30][31] and studies focusing on secondary hemostasis, anticoagulant pathways, or fibrinolysis (n ¼ 17). [32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48] As many studies measure several markers of both secondary hemostasis, anticoagulant pathways as well as fibrinolysis, these studies are listed under a shared header, but data are subdivided into the relevant entities below. Nineteen of the studies employing dynamic assays also reported data from conventional or quantitative coagulation assays.…”

“…32,36,[39][40][41][42][43][44] In accordance with this, fibrin degradation products (FDPs) were also increased in the studies by Ebihara et al, Sasaki et al, and Tsementzis et al 40,43,62 Only two studies found a mean D-dimer within reference range. 35,57 All studies measuring TAT found it elevated when compared with a healthy control group. 38,39,42,44,[49][50][51] This was in accordance with the studies finding increased levels of prothrombin fragment (F) 1 þ 2 40,51 and fibrinopeptide A.…”

“…37 Prothrombin time (PT), international normalized ratio (INR), and activated partial thromboplastin time (aPTT) were all consequently within reference ranges. 35,37,42,[49][50][51]53,65,66…”