ORIGINAL ARTICLE

Levels of protein C, protein S, and anti-thrombin III in acute ischemic stroke patients at Haj Adam Malik Hospital, Medan

Jenie Erawati Muchti , Yuneldi Anwar, Adi Koesoema Aman

Jenie Erawati Muchti
Department of Clinical Pathology, School of Medicine, University of North Sumatera/Haj Adam Malik Hospital Medan, Indonesia. Email: jenie_em@yahoo.com

Yuneldi Anwar
Department of Neurology, School of Medicine, University of North Sumatera/Haj Adam Malik Hospital Medan, Indonesia

Adi Koesoema Aman
Division of Haematology, Department of Clinical Pathology, School of Medicine, University of North Sumatera/Haj Adam Malik Hospital Medan, Indonesia
Online First: August 01, 2019 | Cite this Article
Muchti, J., Anwar, Y., Aman, A. 2019. Levels of protein C, protein S, and anti-thrombin III in acute ischemic stroke patients at Haj Adam Malik Hospital, Medan. Bali Medical Journal 8(2). DOI:10.15562/bmj.v8i2.1378


Background: Ischemic stroke is a clinical syndrome with rapid brain function loss due to a disturbance of blood supply to the brain. The role of natural anticoagulants protein C, protein S and antithrombin III (AT III) in ischemic stroke is still unknown. This study aimed to determine the differences in the levels of protein C, protein S and AT III, which were examined on days 1, 3 and 7 of acute ischemic stroke during treatment.

Methods: This was a longitudinal prospective study carried out in Haj Adam Malik General Hospital Medan, from January to May 2018. This study included 21 acute ischemic stroke patients with three times of sampling (day 1, 3 and 7). Protein C, protein S and AT III were examined using the Coatron A4 device. Protein C and AT III were examined using chromogenic assay principles and protein S using clotting assay principles.

Results: Twenty-one patients who participated in this study were 12 men (57.1%) and nine women (42.9%). There was no significant difference in the level of protein C (p = 0.980), protein S (p = 0.680) and AT III (p = 0.872) between day 1, 3, and 7. There was a positive correlation in protein C, protein S and AT III levels between day 1, 3, and 7. There was a negative correlation between protein C and AT III levels on day 3 (r: - 0.498; p: 0.022).

Conclusion: There was no significant difference in the level of protein C, protein S and antithrombin III between day 1, 3, and 7.

References

Shaikh MK, Makhija P, Baloch ZAQ, Mughal MF, Devrajani BR, Shaikh S, Das T. C-Reactive Protein in Patients with Ischemic Stroke. World Appl Sci J. 2011; 15(9): 1220 – 4.

Feigin VL, Norrving B, Mensah GA. Global Burden of Stroke. Circ Res. 2017; 120(3): 439 – 448. DOI: 10.1161/CIRCRESAHA.116.308413.

Kementerian Kesehatan RI. Badan Penelitian dan Pengembangan Kesehatan. Riset Kesehatan Dasar. Riskesdas 2013. Jakarta: Kementerian Kesehatan RI; 2013.

Assogba K, Belo M, Apetse KM, Sonhaye L, Balogou KAA. Protein S Deficiency and Ischemic Stroke. Global J Med Res: A Neur Nerv Sys. 2014; 14(2): 11-2.

Mayer SA, Sacco RL, Hurlet-Jensen Ann, Shi T, Mohr JP. Free protein S deficiency in acute ischemic stroke. A case-control study. Stroke. 1993; 24(2): 224 – 7.

Hooda A, Khandelwal PD, Saxena P. Protein S deficiency: Recurrent ischemic stroke in young. Ann Indian Acad Neurol. 2009; 12(3): 183 – 4. DOI: 10.4103/0972-2327.56319.

Haapaniemi E, Tatlisumak T, Soinne L, Syrjälä M, Kaste M. Natural anticoagulants (antithrombin III, protein C, and protein S) in patients with mild to moderate ischaemic stroke. Acta Neurol Scand. 2002; 105(2): 107-114.

Chen WH, Lan MY, Chang YY, Chen SS, Liu JS. The prevalence of protein C, protein S, and antithrombin III deficiency in non-APS/SLE Chinese adults with noncardiac cerebral ischemia. Clin Appl Thromb Hemost. 2003; 9(2): 155-162.

Sofyan AM, Sihombing IY, Hamra Y. Hubungan Umur, Jenis Kelamin, dan Hipertensi dengan Kejadian Stroke. Medula J. 2013; 1(1); 24-30.

Price S, Wilson L. Patofisiologi : Konsep Klinis Proses - Proses Penyakit. Jakarta: EGC; 2006.

Abdullah A, Ssefer V, Ertugrul U, Osman E, Esref A, Ugur CM et al. Evaluation of serum oxidant/antioxidant balance in patients with acute stroke. J Pak Med Assoc. 2013; 63(5): 590 – 593.

Misbach J. Jannis J. Diagnosis Stroke. Dalam: Soertidewi L & Jannis J, Stroke, Aspek Diagnostik, Patofisologi, Manajemen. Jakarta: Badan Penerbit FK UI; 2011: 57-84.

De Jesus Llibre J, Valhuerdi A, Fernandez O, Llibre JC, Porto R, Lopez AM et al. Prevalence of stroke and associated risk factors in older adults in Havana City and Matanzas Provinces, Cuba (10/66 population-based study). MEDICC Rev. 2010; 12(3): 20 – 26.

Sorganvi V, Kulkarni M, Kadeli D. Atharga S. Risk Factors for Stroke: A Case Control Study. Int J Curr Res Rev. 2014; 6(3): 46 – 52.

Kulshreshtha A, Anderson LM, Goyal A, Keenan NL. Stroke in South Asia: a systematic review of epidemiologic literature from 1980 to 2010. Neuroepidemiology. 2012; 38(3): 123 – 9. DOI: 10.1159/000336230.

Farida Oesman & Rahajuningsih D Setiabudy. Fisiologi Hemostasis dan Fibrinolisis. Hemostasis dan Trombosis. Jakarta: FK UI; 2009: 1-15.

Tiong IY, Alkotab ML, Ghaffari S. Protein C deficiency manifesting as an acute myocardial infarction and ischaemic stroke. Heart. 2003; 89(2): E7.

Bose K, Saha S, Das KK, Kundu C. A rare cause of acute ischaemic stroke due to combined deficiency of protein C and protein S in an infant. Sri Lanka J Child Health. 2017; 46(2): 172 – 174. DOI: 10.4038/sljch.v46i2.8276.

Piazza O, Scarpati G, Cotena S, Lonardo M, Tufano R. Thrombin antithrombin complex and IL-18 serum levels in stroke patients. Neurol Int. 2010; 2(1): e1. DOI: 10.4081/ni.2010.e1.

Castellino FJ, Ploplis VA. The protein C pathway and pathologic processes. J Thromb Haemost. 2009; 7 Suppl 1: 140 – 5. DOI: 10.1111/j.1538-7836.2009.03410.x.

Moster ML. Coagulopathies and arterial stroke. J Neuroopthalmol. 2003; 23(1): 63 – 71.


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