Activated protein C resistance in patients with arterial ischemic stroke.
BACKGROUND
Activated C protein resistance (APC-R) has recently been reported to be a common cause of thrombophilia; it may be acquired or caused by a genetic defect (factor V Leiden mutation). It is clear that there is an association between APC-R and venous thrombosis. It has been suggested that there is a possible relationship of APC-R with arterial ischemic stroke (IS), but case-control studies have not given enough clues for considering APC-R as a main risk factor.


OBJECTIVE
To assess the incidence of APC-R in patients with IS of several ethiologies in Buenos Aires.


METHODS
Seventy-two patients with IS were assessed for signs or symptoms of previous clinical thrombophilia and the presence of vascular risk factors (RF). They were searched for APC-R (COATEST, APC resistance-V, with a predilution of the samples) test. Determinations were carried out between 1 to 4 months after the ischemic episode. The plasma of 50 healthy control subjects (blood donors) was used as controls.


RESULTS
None of the patients had signs of previous thrombophilia; 57 (79.2%) had RF for IS, and 3 (4.2%) had APC-R (all of them with RF). One subject in the control group (2%) showed a low APC response (1/50). The occurrence of APC-R among patients with stroke was not significantly higher when compared with the occurrence of APC-R among the control subjects.


CONCLUSIONS
In the present series, the incidence of factor V Leiden related APC-R in the group with IS was similar to the healthy population. Other risk factors were associated in patients showing APC-R.
Rey
R C
RC
Department of Neurology, Ramos Mejia Hospital, Buenos Aires, Argentina.
de Larrañaga
G
G
Lepera
S
S
Cohen
M
M
Saposnik
G
G
Alonso
B
B
Sica
R E
RE