Abnormal Changes in Some Haemostatic Parameters in First-ever Stroke Patients in Port Harcourt, Nigeria: A Preliminary Findings

Main Article Content

Fiekumo Igbida Buseri
Serekara Gideon Christian
Evelyn Mgbeoma Eze


Background and Purpose: Cellular component and clotting factors are involved in thrombotic events such as stroke, but the type and nature of alteration of those haemostatic parameters remain unclear. Our objective was to identify possible abnormal changes in some haemostatic parameters in established stroke patients.

Materials and Methods: This was a prospective case-control study conducted at Braithwaite Memorial Specialist Hospital, Port Harcourt, Nigeria. Standard operating procedures were adopted to assay fibrinogen, antithrombin, tissue plasminogen activator, prothrombin time and activated partial thromboplastin time as well as the determination of platelet count and platelet indices. The data were analyzed using Statistical Package for Social Science (SPSS) version 17.0 software.

Results: A total of 108 individuals comprised of 54 stroke patients aged between 45 and 73 years (mean, 59± 13.04 years), 20 (37.04%) men and 34 (62.96%) women and another 54 age- and sex-matched healthy control subjects were studied. Significantly (p<0.05) higher mean values of mean platelet volume (MPPV), platelet distribution width (PDW), Platelet larger cell ratio (PLCR), antithrombin, tissue plasminogen activator and fibrinogen were observed in the stroke patients when compared to those of the control subjects. Whereas, significantly lower (p<0.05) mean values of platelet count, prothrombin time and activated partial thromboplastin time were observed in the stroke patients than in those of the control subjects.

Conclusion: Several haemostatic parameters were found to be altered in stroke patients and have the potential to be risk factors but have not been demonstrated as being causative. Further work is needed to establish where they begin to contribute to stroke prognosis.

Stroke patients, haemostatic parameters, Port-Harcourt, Nigeria

Article Details

How to Cite
Buseri, F., Christian, S., & Eze, E. (2019). Abnormal Changes in Some Haemostatic Parameters in First-ever Stroke Patients in Port Harcourt, Nigeria: A Preliminary Findings. Journal of Advances in Medicine and Medical Research, 29(11), 1-9. https://doi.org/10.9734/jammr/2019/v29i1130138
Original Research Article

Article Metrics


Simard JM, Sahuquillo J, Sheth KN, Kahle KT, Walcott BP. Managing malignant cerebral infarction. Curr Treat Options Neurol. 2011;13(2):217–229.
DOI: 10.1007/s11940-010-0110-9

Thompson JE. The evolution of surgery for the treatment and prevention of stroke - The Willis lecture. Stroke. 1996;27(8): 1427–1434.

American Stroke Association: What is a Stroke/Brain Attack? National Stroke Association; 2014.
[Retrieved July 14, 2015]

Guercin F, Acciarresi M, Agnelli G, Paciaronii M. Cryptogenic stroke: Time to determine aetiology. Journal of Thrombosis and Haemostasis. 2008;6:549–554.

Donnan GA, Fisher M, Macleod M, Davis SM. Stroke. Lancet. 2008;371(9624): 1612–1623.

Fujii Y, Takeuchi S, Harada A, Abe H, Osamu S, Tanaka R. Haemostatic activation in spontaneous intracerebral haemorrhage. Stroke. 2001;32:883-890.

WHO. The top ten causes of death; 2012.
[Accessed March 3 2014]

Desalu OO, Wahab KW, Fawale B, Olarenwaju TO, Busari OA, Adebowale O, Adekoya AO, Oluwafemi Afolayan JO. A review of stroke admissions at a tertiary hospital in rural Southwestern Nigeria. Annals of African Medicine. 2011;10(2): 79-85.

Njoku CH, Aduloju AB. Stroke in Sokoto, Nigeria: A five year retrospective study, Annals of African Medicie. 2004;3(2):73– 76.

Shah PA, Mir RA, Kamdi MMA, Bardi GH, Masordi ZA. Role of mean platelet volume in Ischaemic stroke. JK Science. 2013; 15(1):136-139.

Whisnant JP. Stroke, population cohorts and clinical trials. Butherworth – Heinemann, Oxford. 1993;1-79.

Pancioll AM, Broderic J, Kothari R, Brott T, Tuchfarber A, Miller R, Khoury J, Jauch E. Public perception of stroke warning signs and knowledge of potential risk factors. JAMA. 1998;279:1293-1298.

Osuntokun BO. Stroke in Africans. Afr J Med Sci. 1997;6:39-55.

Holroyd-Leduc JM, Kapral MK, Austin PC, Tu JV. Sex differences and similarities in the management and outcome of stroke patients. Stroke. 2000;31:1833-1837.

Di Napoli, M, Papa F, Bocola V. Prognostic influence of increased C - Reactive protein and fibrinogen levels in Ischemic stroke. Stroke. 2001;32:133-138.

Izilbash N, Jones L, Charles W, Mann J. Fibrinogen and lipid concentrations as risk factors for transient ischaemic attacks and minor ischaemic strokes l BMJ. 1991;303: 605-609.

Di Napoli M, Singh P. Is plasma fibrinogen useful in evaluating ischemic Stroke patients? Why, how, when. Stroke. 2009; 40:1549–1552.

Kario K, Yano Y, Matsuo T, Hoshide S, Eguchi K, Shimada K. Additional impact of morning blood pressure surge on stroke risk in older Japanese hypertensive patients. European Heart Journal. 2011; 32:574-580.

Stanford SN, Sabra A, D’Silva L, Lawrence M, Morris RHK, Storton S, Brown MR, Evans V, Hawkins K, Williams PR, Davidson SJ, Wani M, Potter JF, Evans PA. The changes in clot microstructure in patients with Ischaemic stroke and the effect of therapeutic intervention: A prospective observational study. Bio-medical Central Neurology. 2015;23:15-35. Paper ID: NOV161970 915 View publication stats.

Di Napoli M, Papa F. Should neurologists measure fibrinogen concentration? Journal of Neurological Science. 2006;246(1-2):5-9.

Petrea RE, Beiser AS, Seshadri S, Kelly-Hayes M, Kase CS, Wolf PA. Stroke in women - Gender differences in stroke incidence and post-stroke disability in the framingham heart study; Stroke. 2009; 40(4):1032–1037.

Levenson J, Giral P, Razavian M, Gariepy J, Simon A. Fibrinogen and silent athero-sclerosis in subjects with cardiovascular risk factors. Arterioscler Thromb Vasc Biol. 1995;15:1263–1268.

Tracy R, Bovil E, Yanez D, Psaty B, Fried L, Heiss G, Lee M, Pollak J, Savage P. Fibrinogen and factor VIII, but not factor VII, are associated with measures of subclinical cardiovascular disease in the elderly. Arterioscler Thromb Vasc Biol. 1995;15:1269–1279.

Tohgi H, Takahashi H, Chiba K, Tamura K. Coagulation-fibrinolysis system in post-stroke patients receiving antiplatelet medication. Stroke. 1993;24:801-804.

Anthovic J, Bakic M, Ignjatovic G, Milenkovic Z, Djuric S, Tasie J, Milenovic M. Blood coagulation and fibrinolys is parameter changes after various types of brain damage. Medicine and Biology. 1998;5(1):44-49.

Tohgi H, Kawashima M, Tamura K, Suzuki H. Coagulation fibrinolysis abnormalities in acute and chronic phases of cerebral thrombosis and embolism. Stroke. 1990; 21:1663-1667.

Orefice G, Grasso A, Fazio N, Vecchio GD, Volpe G, Coppola M, D’Allessio A, Carrieri PB. No effect of cloricromen on some coagulation parameters in patients with Ischaemic cerebrovascular disease. The Journal of International Medical Research. 1994;22:287-291.

Catto AJ, Grant PJ. The risk factors for cerebrovascular disease and the role of coagulation and fibrinolysis. Blood Coagul Fibrinolysis. 1995;6:497-510.

Dougherty JH, Levy DE, Weksler BB. Platelet activation in acute cerebral ischaemia. Lancet. 1997;1:821–824.

Butterworth RJ, Bath PMW. The relation-ship between mean platelet volume, stroke subtypes and clinical outcome. Platelet. 1998;9:359-364.

Mdlley TO, Langhorne P, Elton RA, Steward C. Platelet size in stroke patients. Stroke. 1995;26:995-999.

Smith NM, Pathansali R, Bath PMW. Platelet and stroke. Vascular Medicine. 1999;4:165–172.

Tohgi H, Suzuki H, Tamura K, Kimura B. Platelet volume, aggregation, adenosine triphosphate release in cerebral throm-bosis. Stroke. 1991;22:17–21.