title: Clinical profile, common thrombophilia markers and risk factors in 85 young Indian patients with arterial thrombosis.
abstract: OBJECTIVE
  Arterial thrombosis may occur consequent to hereditary thrombophilia and increased lipoprotein(a) [Lp(a)] and fibrinogen. Our aim was to study the prevalence of common thrombophilia markers in 85 consecutive cases of arterial thrombosis.
  
  
  METHODS
  A retrospective study was conducted from 85 consecutive young patients treated as outpatients or admitted due to stroke or myocardial infarction at a tertiary care hospital.
  
  
  METHODS
  Eighty-five Indian patients (age < 45 years) presenting ischemic stroke (n = 48) or myocardial infarction (n = 37) and 50 controls were studied for seven thrombophilia markers including antithrombin (AT), factor V, protein C, protein S, activated protein C resistance (APC-R), fibrinogen and Lp(a). Functional assays for protein C, protein S, factor V and APC-R were performed using clotting-based methods. Semi-quantitative estimation of fibrinogen was done using Clauss's method and Lp(a) using immunoturbidimetry. Statistical analysis was done using the Epi Info 6 software.
  
  
  RESULTS
  Thirty-three samples (38.8%) tested positive for one or more thrombophilia markers. The three commonest abnormalities were elevated Lp(a) (20%), fibrinogen (17.6%) and low APC-R (14.2%). Low levels of protein C, protein S and AT were present in 4.7, 9.4 and 7% of the patients, respectively. Overall, the risk factor profile was: smoking (33%), positive family history (15.3%), hyperlipidemia (7%), hypertension, diabetes mellitus and obesity (2.3% each).
  
  
  CONCLUSIONS
  An association was found between low levels of protein C, protein S and AT and arterial thrombosis, but only elevated fibrinogen levels, smoking, positive family history and hyperlipidemia showed statistical significance.
authors.affiliation: Department of Pathology, Dr. Lal Path Labs Pvt Ltd., New Delhi, India.
authors.forename: Mahendra Narain
authors.initials: MN
authors.lastname: Mishra
authors.affiliation: Department of Cardiology, Indian Naval Hospital Ship Asvini, MumbaiMaharashtra, India.
authors.forename: Ravi
authors.initials: R
authors.lastname: Kalra
authors.affiliation: Department of Neurology, Command Hospital, ChandimandirHaryana, India.
authors.forename: Shalesh
authors.initials: S
authors.lastname: Rohatgi
mesh_terms: D020016:Activated Protein C Resistance / Q000097:blood; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000991:Antithrombins / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001798:Blood Proteins / Q000032:analysis; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007194:India; D008074:Lipoproteins / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000150:complications; D012016:Reference Values; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000097:blood; D020521:Stroke / Q000097:blood* / Q000150:complications; D062606:Tertiary Care Centers; D019851:Thrombophilia / Q000097:blood* / Q000209:etiology; D013927:Thrombosis / Q000097:blood* / Q000150:complications; D055815:Young Adult
chemical_list: D000991:Antithrombins; D015415:Biomarkers; D001798:Blood Proteins; D008074:Lipoproteins