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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
21

Fibrinolytic adaptations to a phase II cardiac rehabilitation program

Nagelkirk, Paul Robert. January 2005 (has links)
Thesis (Ph. D.)--Michigan State University, 2005. / Includes bibliographical references (leaves 51-64)
22

Protease fibrinolítica de Mucor subtilissimus UCP 1262 : produção, purificação, caracterização bioquímica e estrutural

SALES, Amanda Emmanuelle 21 December 2015 (has links)
Submitted by Mario BC (mario@bc.ufrpe.br) on 2016-05-19T12:14:27Z No. of bitstreams: 1 Amanda Emmanuelle Sales.pdf: 4982712 bytes, checksum: 90011cbdafe7a0363213b2fff5735b44 (MD5) / Made available in DSpace on 2016-05-19T12:14:27Z (GMT). No. of bitstreams: 1 Amanda Emmanuelle Sales.pdf: 4982712 bytes, checksum: 90011cbdafe7a0363213b2fff5735b44 (MD5) Previous issue date: 2015-12-21 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Fibrinolytic proteases are enzymes that degrade fibrin, the main component of blood clots. The accumulation of this protein leads to thrombosis responsible for cardiovascular disease including myocardial infarction. A promising alternative to thrombolytic therapy has been the production of these enzymes by microorganisms which promotes low cost, high efficiency and capacity for large scale production. This study aimed to select species of filamentous fungi isolated from Caatinga soil samples - Pernambuco - Brazil and assess their potential for production of proteases with fibrinolytic activity. Among the 36 isolates studied, 58% showed fibrinolytic activity above 100 U/mL. The microorganism with the higher activity in terms of enzyme production was Mucor subtilissimus UCP 1262 with 415 U/mL. Further optimization of the fermentation process resulted in the production of 1075 U/mL of enzymatic activity. The fibrinolytic enzyme had a capacity of enzymatic degradation of the blood clot of 16.7 % in vitro. Extraction of fibrinolytic protease produced at submerged fermentation was carried out using a PEG/ammonium sulphate aqueous two-phase system (ATPS). PEG 8000 15% and 25% ammonium sulphate were selected as the most appropriate components for extraction with Fibrinolytic Activity in salt phase: 345 U/mL; K: 0.65; Y: 253.1 % and FP: 8.8. The fibrinolytic enzyme from Mucor subitilissimus UCP 1262 was pre-purified using extractive fermentation in PEG and ammonium sulphate ATPS, in which the fungal strain was able to grown even in high salt concentration, produced and extracted simultaneously to the PEG phase. A novel protease with fibrinolytic activity was purified also by chromatographic methods using a two-step purification protocol. Compared to the crude enzyme extract, the specific activity of the enzyme increased 5.30 fold with a recovery of 36.31%. The initial crude extract with the enzyme was pre-purified using acetone precipitation and adsorbed by ion exchange chromatography on DEAE-sephadex G50. The two-dimensional electrophoresis system (2DE) coupled with SDS-PAGE showed a single protein band of approximately 15.3 kDa and isoelectric focusing point of 3.9, exhibiting a nature as an acidic enzyme. Additionally, the activity was slightly inhibited by EDTA, but significantly inhibited by PMSF and also had a higher affinity for the N-Succinyl-Ala-Ala-Pro-Phe p-nitroanilide (SAApNA) and azocasein substrates, suggesting to be a chymotrypsin-like protease. Protein unfolding induced by pH and temperature were applied to study the protein conformational changes and showed from the thermal denaturation curve, change in ellipticity at 222 nm, indicated Tm (Melting temperature) of the protein to be 58.14°C. The far UV circular dichroism (CD) of the fibrinolytic protease showed the secondary structure with most content percentage of α-helix. These results demonstrate an economical, viable enzyme purification protocol. And studying the purified fibrinolytic enzyme have established basis for elucidating mechanisms responsible for the changes in conformation of the new fibrinolytic enzyme under varying conditions of temperature and pH. This novel fibrinolytic enzyme may represent a new source of therapeutic agents to treat thrombosis diseases. / Proteases fibrinolíticas são enzimas que degradam a fibrina, o principal componente dos coágulos sanguíneos. O acúmulo da fibrina nos vasos sanguíneos leva a trombose, fenômeno responsável por doenças cardiovasculares. Uma alternativa promissora para a terapia trombolítica tem sido a produção dessas enzimas por micro-organismos que promovem baixo custo, alta eficiência e capacidade de produção em larga escala. Produzir proteases fibrinolíticas por linhagens de fungos filamentosos por fermentação submersa e desenvolver o processo de purificação utilizando Sistemas de Duas Fases Aquosas (SDFA) e cromatografia líquida, além de caracterizar bioquímico e estruturalmente a enzima. Dentre as 36 espécies estudadas, 58% apresentaram atividade fibrinolítica acima de 100 U/mL A espécie com maior atividade foi Mucor subtilissimus UCP 1262 com 415 U/mL. Foram realizados processos fermentativos que resultaram na produção de 1075 U/mL de atividade fibrinolítica, com capacidade de degradação do coágulo sanguíneo de 16,7% in vitro. A extração da protease fibrinolítica produzida por fermentação submersa foi realizada utilizando o sistema de duas fases aquosas (SDFA) com Polietileno glicol (PEG) e sulfato de amônio. O PEG 8000 (g/mol) a 15% e sulfato de amônio a 25% foi selecionado como a condição mais eficiente para a extração da enzima na fase do sal, apresentando 345 U/mL de atividade, coeficiente de partição K=0,65; Recuperação Y=253,1% e Fator de purificação FP=8,8. A protease fibrinolítica produzida por Mucor subitilissimus UCP 1262 foi também pré-purificada utilizando fermentação extrativa com SDFA (PEG e sulfato de amônio), onde a espécie fúngica foi capaz de crescer mesmo em altas concentrações de sal, produzir e extrair simultaneamente para a fase do PEG do sistema. A protease fibrinolítica foi purificada também através de métodos cromatográficos utilizando um protocolo de purificação com dois passos. O extrato bruto inicial com a enzima foi pré-clarificado utilizando precipitação com acetona e adsorção em cromatografia de troca-iônica em DEAE-sephadex G50, o qual foi capaz de aumentar a pureza em 5,30 vezes com a recuperação de 36, 31%. O sistema de eletroforese bidimensional 2DE acoplado ao SDS-PAGE mostrou uma banda única de aproximadamente 15,3 kDa e a focalização isoelétrica apresentou o ponto isoelétrico no pH 3,9, exibindo uma natureza de enzima ácida. Adicionalmente a enzima foi significativamente inibida por PMSF e alta afinidade catalítica para o substrato sintético amidolítico N-Succinyl-Ala-Ala-Pro-Phe p-nitroanilide (SAApNA) e azocaseína. Sugerindo ser uma serino-protease semelhante à quimotripsina. Desdobramento proteico induzido por pH e temperatura foram aplicados para estudar as mudanças conformacionais da enzima e mostraram através da curva de desnaturação térmica, mudança da elipticidade a 222 nm, indicando um Tm (Temperatura de desnaturação) da proteína de 58,14°C. O dicroísmo circular no UV distante (far UV CD) da protease fibrinolítica mostrou a estrutura secundária da proteína com maior teor de α-hélix. Estes resultados demonstram um protocolo de purificação de enzimas eficiente. E o estudo da enzima purificada estabeleceu bases para elucidar mecanismos responsáveis pelas mudanças de conformação de uma nova enzima fibrinolítica sob a variação de condições variadas de temperatura e pH. Esta enzima fibrinolítica pode representar uma nova fonte de agente terapêutico no tratamento de doenças trombolíticas.
23

Atividade plasmina simile e sequencia parcial de enzima fibrino(geno)litica do veneno de Bothrops lanceolatus (Fer de lance)

Sant'Ana, Christina Maria de 19 August 2005 (has links)
Orientador: Albetiza Lobo de Araujo / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-05T20:58:23Z (GMT). No. of bitstreams: 1 Sant'Ana_ChristinaMariade_M.pdf: 302187 bytes, checksum: 422061925f0c5378a445c566afe71b75 (MD5) Previous issue date: 2005 / Resumo: O envenenamento botrópico leva ao desenvolvimento de eventos como necrose, hemorragia e distúrbios da coagulação, gerando um quadro fisiopatológico de grande complexicidade. O trabalho de Lôbo de Araújo et al. de 1998 descreveu uma proteína de cadeia polipeptídica simples (PII1A), a qual apresentou atividade enzimática tipo esterolítica, proteína esta, proveniente do veneno da Bothrops lanceolatus, uma serpente habitante da ilha da Martinica, no Caribe. A imunodifusão e a imunoeletroforese apresentaram uma linha simples de imunoprecipitado. A fração em questão ainda hidrolisou as cadeias a e b do fibrinogênio, o que levou a classificar esta proteína como uma enzima fibrino(geno)lítica. No presente trabalho, nos propusemos a dar continuidade ao estudo desta proteína parcialmente purificada e caracterizada e investigar sua atividade como ativadora de plasminogênio ou portadora de atividade fibrinolítica, assim a atividade plasmina símile foi determinada pela ação da proteína diretamente sobre substrato cromogênico específico (S-2251ä), estando de acordo com achados publicados por Lôbo de Araújo et al (1998) e que revelou também discreta atividade ativadora de plasminogênio, quando compara-se incubação na presença e ausência deste. Determinamos 71% da seqüência de aminoácidos da PII1A por espectrometria de massa ¿ Q-tof, este método revelou um peso molecular de 28.360 kDa. A análise da seqüência em base de dados mostrou homologia com outras proteínas se serpentes e com enzimas como tripsina e fatores da cascata de coagulação / Abstract: The main symptoms following bothropic envenoming are necroses, hemorrhage and coagulopathies, originating a characteristic and complex phisiopathology. The work of Lôbo de Araújo et al. (1998) described a single polipeptide chain protein (PII-1A) purified from Bothrops lanceolatus venom, a snake inhabitant of the Martinica island. The immunodiffusion and immunoeletrophoresis analysis showed a single immunoprecipitin line. This protein was characterized as a fibrino(geno)lytic enzyme since was able to hydrolyze the a and b chains of fibrinogen. Using synthetic substrates, the authors demonstrated a strong sterolytic activity against p-TAME. In the present work we continue to study this protein (PII-1A) investigating its activity to activate plasminogen or to present a direct fibrinolytic activity using S-2251ä substrate. The determination of its partial sequence, including N-terminal, was carried through by mass spectrometry - Q-tof that showed molecular weight 28.369 kDa / Mestrado / Farmacologia / Mestre em Farmacologia
24

Actividad fibrinolitica en venenos de serpientes peruanas de los géneros bothrops, lachesis y crotalus / Actividad fibrinolitica en venenos de serpientes peruanas de los géneros bothrops, lachesis y crotalus

Collantes, Hugo G., Zavaleta Martínez-Vargas, Alfonso, Salas, Maria 25 September 2017 (has links)
Se estudia la presencia de actividad fibrinolítica en los venenos de cinco serpientes peruanas empleando coágulos de fibrina formados a partir de fibrinógeno bovino y una enzima semejante a trombina de L. muta muta parcialmente purificada Los cinco venenos estudiados presentaron actividad fibrinolítica en ausencia de plasmina (rango: 16,3 a 57,5 U/h mg protefua), lo que demuestra la existencia de enzimas proteolíticas en los venenos de vipéridos peruanos, que actúan directamente sobre la fibrina. El veneno de L. muta muta presentó la mayor actividad enzimática específica (57 ,5), seguido en orden decreciente por B. barnetti (45,2),B.pictus (29,4), C. durisus terrificus (22,5) y B. brazilü (16,3). / We studied the presence of fibrinolytic activity in five dried peruvian snake venoms using fibrin clots formed by one partially purified fraction of Thrombin-like enzyme from L. muta muta. In all venoms studied, fibrinolysis were detected in absence of plasmin in the range from 16,3 to 57,5 U/h mgprotein. This results demonstrate the existence of proteolytic enzymes in Peruvian Viperid snake venoms that act upon fibrin. The L. muta muta venom showed the higher activity (57 ,5), followed in down order by B. barnetti (45,2) B. pictus (29,4), C. durisus terrificus (22,5) and B. brazilü venom (16,3).
25

Plasmin administration during ex vivo lung perfusion ameliorates lung ischemia-reperfusion injury / 体外肺灌流中のプラスミン投与は、肺の虚血再灌流障害を軽減する

Motoyama, Hideki 25 May 2015 (has links)
京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第19173号 / 医博第4015号 / 新制||医||1010(附属図書館) / 32165 / 京都大学大学院医学研究科医学専攻 / (主査)教授 木村 剛, 教授 福田 和彦, 教授 小池 薫 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM
26

Produção de protease com atividade fibrinolítica por cultivo submerso de Mucor subtilissimus em biorreator. / Production of protease with fibrinolytic activity by submerged culture of Mucor subtilissimus in bioreactor.

Juliano Costa Buba 05 October 2017 (has links)
As doenças cardiovasculares (DCVs) são um grupo de desordens do coração e dos vasos sanguíneos capazes de causar ataques cardíacos e acidentes vasculares cerebrais, eventos geralmente agudos oriundos principalmente de bloqueios que impedem o sangue de fluir para o coração ou o cérebro. Proteases fibrinolíticas são agentes que degradam a fibrina, principal componente de trombo sanguíneo, capazes de evitar e tratar DCVs. Fungos filamentosos têm se mostrado uma boa alternativa para a produção de enzimas fibrinolíticas, dentre esses os fungos da divisão dos zigomicetos. A cepa UCP 1262 do zigomiceto Mucor subtilissimus foi estudada com o objetivo geral de produzir protease com atividade fibrinolítica com base em trabalhos publicados em fermentação em estado sólido (FES) e cultivo submerso com a mesma cepa. Foram realizados cultivos submersos desta cepa em frascos agitados e em 2 diferentes biorreatores, com determinação da cinética de crescimento, consumo de glicose e produção de enzima. O meio utilizado foi o MS-2, com farelo de trigo como fonte de nitrogênio e glicose como fonte preferencial de carbono. A FES com a mesma fonte de nitrogênio e o cultivo submerso em diferentes condições de taxa de inóculo, pH e agitação deste estudo foram comparados, assim como duas metodologias diferentes para dosagem de concentração de biomassa, gravimetria e ergosterol. As maiores concentrações de atividade fibrinolítica e produtividade volumétrica obtidas foram de, respectivamente, 12,0 U/mL e 0,22 U/(mL.h), 92% e 89% menores, respectivamente, do que o valor reportado em FES. O valor de ?Xmax foi calculado com base no perfil de biomassa, glicose e produção de CO2 e não apresentou correlação com a produção da enzima. A maior simplicidade operacional e os dados de rendimento obtidos indicam que a FES é uma alternativa melhor para a produção dessa enzima com esta cepa. O zigomiceto Mucor subtilissimus demonstrou ser muito difícil de ser cultivado em sistemas submersos com o meio MS-2, em especial pela sua morfologia e aderência ao biorreator. / Cardiovascular diseases (CVDs) are a group of heart and blood vessels disorders capable of causing heart attacks and strokes, usually acute events caused mainly by blockages that prevent blood from flowing to the heart and brain. Fibrinolytic proteases are agents that degrade fibrin, the major component of blood thrombus. Filamentous fungi were shown to be a good alternative for the production of fibrinolytic enzymes, among them fungi of the zygomycetes division. The UCP 1262 strain of the zygomycete Mucor subtilissimus was studied with the general objective of producing protease with fibrinolytic activity based on published works on solid state fermentation (SSF) and submerged culture with the same strain. Submerged cultures of this strain were carried out in shaken flasks and in 2 different bioreactors, with determination of growth kinetics, glucose consumption and enzyme production. The medium used was MS-2, with wheat bran as the nitrogen source and glucose as the preferred carbon source. The SSF with the same nitrogen source and the submerged culture under different inoculum ratios, pH and agitation conditions of this study were compared, as well as two different methodologies for biomass, gravimetry and ergosterol dosage. The highest concentration of fibrinolytic activity and volumetric productivity obtained were, respectively, 12.0 U/mL and 0.22 U/(mL.h), 92% and 89% lower, respectively, than the value reported in SSF. The value of ?Xmax was calculated based on the biomass concentration, glucose and CO2 production profile and showed no correlation with the enzyme production. The greater operational simplicity and yield data obtained indicate that SSF is a better alternative for the production of this enzyme with this strain. The zygomycete Mucor subtilissimus showed to be very difficult to cultivate in submerged culture with the MS-2 medium, especially for its morphology and adherence to the bioreactor.
27

Produção de protease com atividade fibrinolítica por cultivo submerso de Mucor subtilissimus em biorreator. / Production of protease with fibrinolytic activity by submerged culture of Mucor subtilissimus in bioreactor.

Buba, Juliano Costa 05 October 2017 (has links)
As doenças cardiovasculares (DCVs) são um grupo de desordens do coração e dos vasos sanguíneos capazes de causar ataques cardíacos e acidentes vasculares cerebrais, eventos geralmente agudos oriundos principalmente de bloqueios que impedem o sangue de fluir para o coração ou o cérebro. Proteases fibrinolíticas são agentes que degradam a fibrina, principal componente de trombo sanguíneo, capazes de evitar e tratar DCVs. Fungos filamentosos têm se mostrado uma boa alternativa para a produção de enzimas fibrinolíticas, dentre esses os fungos da divisão dos zigomicetos. A cepa UCP 1262 do zigomiceto Mucor subtilissimus foi estudada com o objetivo geral de produzir protease com atividade fibrinolítica com base em trabalhos publicados em fermentação em estado sólido (FES) e cultivo submerso com a mesma cepa. Foram realizados cultivos submersos desta cepa em frascos agitados e em 2 diferentes biorreatores, com determinação da cinética de crescimento, consumo de glicose e produção de enzima. O meio utilizado foi o MS-2, com farelo de trigo como fonte de nitrogênio e glicose como fonte preferencial de carbono. A FES com a mesma fonte de nitrogênio e o cultivo submerso em diferentes condições de taxa de inóculo, pH e agitação deste estudo foram comparados, assim como duas metodologias diferentes para dosagem de concentração de biomassa, gravimetria e ergosterol. As maiores concentrações de atividade fibrinolítica e produtividade volumétrica obtidas foram de, respectivamente, 12,0 U/mL e 0,22 U/(mL.h), 92% e 89% menores, respectivamente, do que o valor reportado em FES. O valor de ?Xmax foi calculado com base no perfil de biomassa, glicose e produção de CO2 e não apresentou correlação com a produção da enzima. A maior simplicidade operacional e os dados de rendimento obtidos indicam que a FES é uma alternativa melhor para a produção dessa enzima com esta cepa. O zigomiceto Mucor subtilissimus demonstrou ser muito difícil de ser cultivado em sistemas submersos com o meio MS-2, em especial pela sua morfologia e aderência ao biorreator. / Cardiovascular diseases (CVDs) are a group of heart and blood vessels disorders capable of causing heart attacks and strokes, usually acute events caused mainly by blockages that prevent blood from flowing to the heart and brain. Fibrinolytic proteases are agents that degrade fibrin, the major component of blood thrombus. Filamentous fungi were shown to be a good alternative for the production of fibrinolytic enzymes, among them fungi of the zygomycetes division. The UCP 1262 strain of the zygomycete Mucor subtilissimus was studied with the general objective of producing protease with fibrinolytic activity based on published works on solid state fermentation (SSF) and submerged culture with the same strain. Submerged cultures of this strain were carried out in shaken flasks and in 2 different bioreactors, with determination of growth kinetics, glucose consumption and enzyme production. The medium used was MS-2, with wheat bran as the nitrogen source and glucose as the preferred carbon source. The SSF with the same nitrogen source and the submerged culture under different inoculum ratios, pH and agitation conditions of this study were compared, as well as two different methodologies for biomass, gravimetry and ergosterol dosage. The highest concentration of fibrinolytic activity and volumetric productivity obtained were, respectively, 12.0 U/mL and 0.22 U/(mL.h), 92% and 89% lower, respectively, than the value reported in SSF. The value of ?Xmax was calculated based on the biomass concentration, glucose and CO2 production profile and showed no correlation with the enzyme production. The greater operational simplicity and yield data obtained indicate that SSF is a better alternative for the production of this enzyme with this strain. The zygomycete Mucor subtilissimus showed to be very difficult to cultivate in submerged culture with the MS-2 medium, especially for its morphology and adherence to the bioreactor.
28

Thrombomodulin/heparin functionalized membrane-mimetic assemblies: strategies for generating an actively anti-thrombogenic surface

Tseng, Po-Yuan 20 July 2005 (has links)
It has been postulated that the control of thrombus formation on molecularly engineered surfaces is an important step in developing clinically durable small-diameter vascular prostheses. This has led to designing a membrane-mimetic assembly that contains physiological regulators of blood coagulation, thrombomodulin (TM) and heparin, to provide strategies for generating actively antithrombogenic surfaces. The membrane-mimetic construct contains polymeric phospholipid monolayer on an alkylated polyelectrolyte multilayer supported by planar substrate such as glass or silicone. When incorporated with TM, the model platform exhibited the biological function by catalyzing activation of protein C. Surface TM activity was extensively investigated at physiologic shear rates (50 sec-1 and 500 sec-1). Significantly, reaction rates become saturated at TM surface densities greater than or equal to ~ 800 fmole/cm2 due to due to a transport limitation. Based on the similar membrane-mimetic construct, a functional heparinized surface was designed as an alternative anticoagulant system. Immobilization of heparin onto membrane-mimetic surfaces was achieved through biotin-streptavidin binding specificity. Activity of surface heparin to facilitate thrombin inactivation was investigated at shear rates of 50 and 500 sec-1. Significantly, rate of thrombin decay becomes saturated when the surface coverage of heparin is higher than 4.4 pmole of heparin per cm2. We further investigated the effects of surface bound TM and heparin on tissue factor (TF) -induced thrombin generation in a flow model. Specifically, TF positioned over a 2 x 6 mm2 upstream region as a trigger for thrombin generation and TM and/or heparin positioned over the remaining downstream (34 x 6 mm2) portion of the test film. Compared to TF alone surface, thrombin generation was profoundly reduced in the presence of surface bound TM and/or heparin. Significantly, thrombin production was maximally inhibited more than 85% in the presence of TM and heparin, possibly due to anticoagulant synergism of both anticoagulants. We believe that current membrane-mimetic systems can potentially create actively antithrombogenic surfaces.
29

Improving outcome in acute myocardial infarction : the creation and utilisation of the Register of Information and Knowledge about Swedish Heart Intensive Care Admissions (RIKS-HIA) /

Stenestrand, Ulf January 2002 (has links) (PDF)
Diss. (sammanfattning) Linköping : Univ., 2002. / Härtill 4 uppsatser.
30

Antiplatelet Medication Management in Patients Hospitalized With Ischemic Stroke

Nickman, Nancy A., Biskupiak, Joseph, Creekmore, Freddy, Shah, Hemal, Brixner, Diana I. 01 November 2007 (has links)
Purpose. The use of antiplatelet agents in patients hospitalized with ischemic stroke was studied. Methods. Patients with a primary or secondary diagnosis of noncardiogenic, thrombotic ischemic stroke from January 2002 through December 2004 were included in the analysis. Patients were then subdivided into four treatment groups and one no-treatment group based on whether they were charged for any of four antiplatelet regimens (low-dose aspirin [≤325 mg daily], extended-release dipyridamole 200 mg with aspirin 25 mg, clopidogrel 75 mg, and clopidogrel 75 mg [as the bisulfate] plus low-dose aspirin) at any time during hospitalization. Patients who did not receive any of these medications during hospitalization were defined as the no-treatment group. A patient's illness severity was measured and compared with other patients in the data set. Results. A total of 44,108 patients were assigned to the treatment group, and 14,255 patients were assigned to the no-treatment group. In general, longer lengths of stay and higher institutional costs were associated with the no-treatment group. Patients in the no-treatment group consistently displayed more comorbid conditions than did patients in the treatment group. The no-treatment group exhibited higher usage rates of both fibrinolytic agents and vitamin K. More patients in the treatment group were discharged to home or rehabilitation, while more patients in the no-treatment group were either discharged to another nursing facility or died before discharge. Conclusion. A retrospective analysis of a large national hospital database revealed that one quarter of patients who suffered an acute stroke did not receive antiplatelet drugs during their patient stay. Outcomes for such patients were poorer than for patients who had received antiplatelet therapy.

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