title: Increased thrombin generation is associated with acute ischemic stroke but not with coronary heart disease in the elderly: the Three-City cohort study.
abstract: OBJECTIVE
  A high thrombin generation level has been associated with the risk of venous thrombosis. Whether changes in this biomarker are relevant to arterial disease remains unknown. We investigated the association of thrombin generation with coronary heart disease (CHD) and acute ischemic stroke (AIS) in the elderly.
  
  
  RESULTS
  We used data from the Three-City study, a prospective cohort including 9294 subjects aged >65 years. After 4 years of follow-up, a case-cohort study was established. Using the calibrated automated thrombography method, endogenous thrombin potential and peak height were measured in plasma samples of all CHD and AIS cases and a random sample of 1177 controls. We did not find any significant association between thrombin generation and CHD. In multivariate analyses, high levels of endogenous thrombin potential and peak height were associated with an increased risk of AIS (hazard ratio=1.16 [95% CI, 0.90 to 1.50] and 1.31 [95% CI, 1.01 to 1.69] for a 1 SD increase, respectively). Data also suggested that these associations might be more important in women (hazard ratio=1.55 [95% CI, 1.05 to 2.33] and 1.71 [95% CI, 1.11 to 2.63], respectively) than in men (P for interaction=0.04 and 0.08, respectively).
  
  
  CONCLUSIONS
  Thrombin generation emerges as an independent predictor of AIS, particularly in women. Hypercoagulability may have an important role in the pathogenesis of AIS.
authors: Institut National de la Santé et de la Recherche Médicale (INSERM), Centre for Research in Epidemiology and Population Health, U1018, Hormones and Cardiovascular Disease, Villejuif, France. laure.carcaillon@inserm.fr
authors: Laure
authors: L
authors: Carcaillon
authors: Martine
authors: M
authors: Alhenc-Gelas
authors: Yannick
authors: Y
authors: Bejot
authors: Christian
authors: C
authors: Spaft
authors: Pierre
authors: P
authors: Ducimetière
authors: Karen
authors: K
authors: Ritchie
authors: Jean-François
authors: JF
authors: Dartigues
authors: Pierre-Yves
authors: PY
authors: Scarabin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001778:Blood Coagulation Disorders / Q000150:complications; D002545:Brain Ischemia / Q000097:blood / Q000209:etiology*; D015331:Cohort Studies; D003327:Coronary Disease / Q000097:blood / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D009154:Mutation; D011446:Prospective Studies; D011516:Prothrombin / Q000235:genetics; D012727:Sex Characteristics; D020521:Stroke / Q000097:blood / Q000209:etiology*; D013917:Thrombin / Q000096:biosynthesis*
chemical_list: D011516:Prothrombin; D013917:Thrombin