title: Risk of stroke in young women and two prothrombotic mutations: factor V Leiden and prothrombin gene variant (G20210A)
abstract: OBJECTIVE
  Factor V Leiden and a prothrombin gene variant, G20210A, are mutations associated with a thrombotic risk. The aim of our study was to assess whether these mutations increase the risk of stroke in women under 45 years of age.
  
  
  METHODS
  We conducted a case-control study in western Washington state. Case patients were women aged 18 to 44 years with a first stroke (n = 106). Control subjects were women without stroke recruited from the same region by use of random-digit telephone dialing (n = 391). All were interviewed and provided blood specimens, which were genotyped for these mutations.
  
  
  RESULTS
  Factor V Leiden was found in 0.9% of case patients, a single patient with a subarachnoid hemorrhage, and in 4.1% of control subjects. The odds ratio (OR) for any stroke was 0.2 (95% confidence interval [CI], 0.03 to 1.7). The prothrombin variant was found in 1.9% of case patients, 1 with a venous stroke and 1 with an ischemic stroke, and in 1.6% of control subjects. The OR for any stroke was 1.48 (95% CI, 0.14 to 9.17). ORs for stroke types were also not statistically significant.
  
  
  CONCLUSIONS
  In this study, neither factor V Leiden nor the prothrombin variant (G20210A) was an important risk factor for stroke in young women. In this setting, screening for these mutations cannot be recommended. Unanswered by this study is whether screening would be useful in select patients, such as those with a strong family history of thrombophilia or those with venous strokes.
authors.affiliation: Department of Neurology, University of Washington, Seattle, USA. wl@u.washington.edu
authors.forename: W T
authors.initials: WT
authors.lastname: Longstreth
authors.forename: F R
authors.initials: FR
authors.lastname: Rosendaal
authors.forename: D S
authors.initials: DS
authors.lastname: Siscovick
authors.forename: H L
authors.initials: HL
authors.lastname: Vos
authors.forename: S M
authors.initials: SM
authors.lastname: Schwartz
authors.forename: B M
authors.initials: BM
authors.lastname: Psaty
authors.forename: T E
authors.initials: TE
authors.lastname: Raghunathan
authors.forename: T D
authors.initials: TD
authors.lastname: Koepsell
authors.forename: P H
authors.initials: PH
authors.lastname: Reitsma
mesh_terms: D000328:Adult; D001778:Blood Coagulation Disorders / Q000235:genetics*; D016022:Case-Control Studies; D002561:Cerebrovascular Disorders / Q000235:genetics*; D005165:Factor V; D005260:Female; D006801:Humans; D011516:Prothrombin / Q000235:genetics*; D012307:Risk Factors; D013927:Thrombosis / Q000235:genetics*
chemical_list: C095381:factor V Leiden; D005165:Factor V; D011516:Prothrombin