Diagnostic yield of prothrombotic state studies in cryptogenic stroke.
OBJECTIVE
Around 30% of ischemic strokes are considered cryptogenic. We analyzed the diagnostic yield of prothrombotic state (PS) studies in patients with an initial cryptogenic stroke (CS).


METHODS
We prospectively included consecutive CS patients according to the TOAST criteria. PS included plasmatic determinations of antiphospholipid (APL) antibodies and lupus anticoagulant (LA), S (SPd) and C (CPd) protein deficiencies, and genetic analysis of the prothrombin gene mutation (PT G20210A) and the factor V Leiden mutation (FV G1691A). We recorded age, sex and vascular risk factors.


RESULTS
From a total of 89 patients (mean age 56.9 +/- 14.3 years, 53% men), we identified 16 PS in 15 patients (16.85%): APL-6, LA-2, SPd-2, CPd-1, PT G20210A -3 and FV G1691A -2. One patient presented an association (APL and PT G20210A).


CONCLUSIONS
One of every six patients with initial CS present a PS. Age or sex and conventional cardiovascular risk factors were not related to PS study findings, supporting the relevance of such studies in all patients with an initial CS.
Belvís
R
R
Stroke Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain. rbelvis@hsp.santpau.es
Santamaría
A
A
Martí-Fàbregas
J
J
Cocho
D
D
Borrell
M
M
Fontcuberta
J
J
Martí-Vilalta
J L
JL
D000328:Adult; D017677:Age Distribution; D000368:Aged; D017152:Antibodies, Antiphospholipid / Q000097:blood; D001777:Blood Coagulation / Q000235:genetics; D002318:Cardiovascular Diseases / Q000150:complications / Q000235:genetics; D005165:Factor V / Q000235:genetics; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics*; D006801:Humans; D016682:Lupus Coagulation Inhibitor / Q000097:blood; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics*; D011446:Prospective Studies; D011486:Protein C / Q000378:metabolism; D017293:Protein S / Q000378:metabolism; D011516:Prothrombin / Q000235:genetics; D012307:Risk Factors; D017678:Sex Distribution; D020521:Stroke / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology; D013927:Thrombosis / Q000097:blood* / Q000175:diagnosis* / Q000235:genetics
D017152:Antibodies, Antiphospholipid; D016682:Lupus Coagulation Inhibitor; D011486:Protein C; D017293:Protein S; C095381:factor V Leiden; D005165:Factor V; D011516:Prothrombin