SERPINE1 and cerebral infarction: Third, Lp(a)’s role in thrombogenicity may be mediated through several additional mechanisms, including platelet activation and aggregation, interaction with tissue factor (TF), inhibition of fibrinolysis by plasmin, and increased expression of plasminogen activator inhibitor-1 (PAI-1), which collectively facilitate thrombus formation in intracranial and extracranial vessels, potentially leading to cerebral infarction [7,65].