title: Hemostatic risk factors in ischemic stroke.
abstract: The role played by hemostasis in the pathogenesis of ischemic stroke is still controversial. In the present study, we looked for a possible association of ischemic stroke and high clotting activity of factor II (FII:C), factor V (FV:C), factor VII (FVII:C), factor X (FX:C) and fibrinogen. We investigated 157 non-anti-coagulated patients (86 males, 71 females; median age 41 y, range 16-73 ), who had survived ischemic stroke for at least 2 months, and 193 healthy controls with similar age and sex distribution (104 males, 89 females; median age 39 y, range 19-74). Patients showed significantly higher body mass index, as well as significantly higher prevalence of arterial hypertension, smoking and hyperlipidemia. FV:C (p = 0.05), FX:C (p = 0.04) and fibrinogen (p = 0.05) were higher in patients as compared to controls. In a univariate risk analysis FX:C and FV:C were associated with the relative risk for ischemic stroke showing an odds ratio (OR) of up to 2.8 (95% CI: 1.05-7.6) and 3.4 (95%CI: 1.4-7.9), respectively, for levels above 130%. In a multivariate analysis using a logistic regression model including age, sex, arterial hypertension, smoking habit, diabetes, hyperlipidemia, BMI and the coagulation factors, FV:C was still found to significantly (p=0.03) add to the risk of ischemic stroke. An increase of factor FV:C by 10% was associated with an increase in the relative risk of 19% (95% CI.: 2%-38%). In conclusion, we found a high plasma level of FV:C to be a prevalent (FV:C > 130% in 20/157 patients) and independent risk factor for ischemic stroke.
authors.affiliation: Central Hematology Laboratory, Inselspital, Universitiy of Bern, CH-3010 Bern, Switzerland. franziska.demarmels.biasiutti@insel.ch
authors.forename: Franziska
authors.initials: F
authors.lastname: Demarmels Biasiutti
authors.forename: Daniela
authors.initials: D
authors.lastname: Berger
authors.forename: Heinrich P
authors.initials: HP
authors.lastname: Mattle
authors.forename: Bernhard
authors.initials: B
authors.lastname: Lämmle
authors.forename: Walter A
authors.initials: WA
authors.lastname: Wuillemin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001779:Blood Coagulation Factors / Q000032:analysis; D002545:Brain Ischemia / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D016022:Case-Control Studies; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006487:Hemostasis; D006801:Humans; D006949:Hyperlipidemias; D006973:Hypertension; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D012907:Smoking; D020521:Stroke / Q000097:blood* / Q000453:epidemiology / Q000209:etiology*
chemical_list: D001779:Blood Coagulation Factors; D005340:Fibrinogen