Anemia as a risk factor for cerebral venous thrombosis? An old hypothesis revisited. Results of a prospective study.
BACKGROUND
Several case reports have linked iron deficiency anemia with the occurrence of cerebral venous thrombosis (CVT) or stroke, yet, it is unclear whether this is a chance association.


METHODS
In a case-control design data of whole blood count and screening for thrombophilic coagulation abnormalities of 121 prospectively identified patients with CVT and 120 healthy controls were compared. Anemia was defined as a hemoglobin (Hb) concentration of <120 g/l in females, and <130 g/l in males, severe anemia as a Hb <90 g/l. Adjusted odds ratios (OR) were calculated based on a logistic regression model treating variables with a level of significance of p < or = 0.2 on univariate analysis as potential confounders.


RESULTS
Thrombophilia (OR 1.22, 95% CI 1.07-1.76, p < 0.01), severe anemia (OR 1.10, 95% CI 1.01-2.22, p < 0.05), and hypercholesterinemia (OR 1.21, 95% CI 1.04-2.57, p < 0.05) were the only independent variables associated with CVT on multivariate analysis.


CONCLUSIONS
Severe anemia is significantly and independently associated with CVT.
Stolz
Erwin
E
Dept. of Neurology, Justus-Liebig-University, Am Steg 14, 35385 Giessen, Germany. Erwin.stolz@neuro.med.uni-giessen.de
Valdueza
José Manuel
JM
Grebe
Mathias
M
Schlachetzki
Felix
F
Schmitt
Eberhard
E
Madlener
Katharina
K
Rahimi
Anousha
A
Kempkes-Matthes
Bettina
B
Blaes
Franz
F
Gerriets
Tibo
T
Kaps
Manfred
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000453:epidemiology*; D001778:Blood Coagulation Disorders / Q000453:epidemiology; D016022:Case-Control Studies; D002550:Cerebral Veins / Q000473:pathology / Q000503:physiopathology*; D015897:Comorbidity; D003392:Cranial Sinuses / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D020767:Intracranial Thrombosis / Q000453:epidemiology* / Q000503:physiopathology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012851:Sinus Thrombosis, Intracranial / Q000453:epidemiology / Q000503:physiopathology; D019851:Thrombophilia / Q000453:epidemiology; D020246:Venous Thrombosis / Q000453:epidemiology* / Q000503:physiopathology*