A study of hemostasis in ischemic cerebrovascular disease. V. A multivariate evaluation of risk indicators and predictors. Early results of a longitudinal study.
The study includes 119 patients with minor ischemic cerebrovascular lesions before the age of 55 during 1976-78. Atherosclerotic signs were found in 65% at aortocranial angiography and/or exercise test (ST depression). Abnormalities in hemostasis (defective fibrinolytic response in 50%, high Factor VIII activity in 45% of those investigated, and high Factor VIII related antigen (VIII R:Ag) in 20%) could not be explained by accumulation of atherosclerotic risk factors as most often no significant independent correlations were found at stepwise multiple regression. Significant correlations with aortocranial atherosclerosis was found for age, VIII R:Ag and blood pressure reaction at exercise test. Only E-SR showed significant correlation to ST depression at exercise test. These results indicate different determinants and risk indicators for atherosclerosis with different locations. An early evaluation of the longitudinal study (mean 42 months' follow up) showed that 16 patients had suffered new occlusive vascular incidents. The malign prognostic subgroup (cerebral or myocardial infarction or death; n = 10) showed significantly higher levels of VIII R:Ag (p less than 0.005) and triglycerides (p less than 0.05) than the benign group (new TIA, n = 6). This indicates that VIII R:Ag may be a useful marker for development of atherosclerosis and predictor for the outcome of ICD.
D000293:Adolescent; D000328:Adult; D000941:Antigens / Q000032:analysis; D001161:Arteriosclerosis / Q000150:complications; D001794:Blood Pressure; D002545:Brain Ischemia / Q000097:blood* / Q000209:etiology; D003276:Contraceptives, Oral / Q000009:adverse effects; D005169:Factor VIII / Q000032:analysis / Q000276:immunology; D005260:Female; D005342:Fibrinolysis; D006487:Hemostasis; D006801:Humans; D008074:Lipoproteins / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D011379:Prognosis; D012044:Regression Analysis; D012306:Risk; D012907:Smoking; D013548:Sweden; D014841:von Willebrand Factor
D000941:Antigens; D003276:Contraceptives, Oral; D008074:Lipoproteins; D014841:von Willebrand Factor; D005169:Factor VIII