Elevated Plasma Factor VIII in Patients with Ischemic Stroke: Does it have any Association with Hypertensive Heart Disease?
BACKGROUND
Elevated factor VIII (FVIII) has been linked with higher risk of vascular events. We aimed to determine the relationship between FVIII and hypertension in patients with acute ischemic stroke.


METHODS
FVIII levels and transthoracic echocardiogram reports were reviewed in patients with acute ischemic stroke who presented to our stroke center between July 2008 and September 2011. Presenting systolic and diastolic blood pressure, history of hypertention, left ventricular hypertrophy, diastolic dysfunction, and depressed left ventricular function (ejection fraction <50%) were compared in patients with normal and elevated FVIII levels.


RESULTS
No differences in presenting blood pressure or frequency of hypertension history were found based on FVIII level. Patients with elevated FVIII had demonstrated a statistically significant higher frequency of diastolic dysfunction (64.8 vs. 43.6%, p=0.042) and a trend towards higher frequency of left ventricular hypertrophy (18.5 vs 5.1%, p=0.073). Median FVIII was significantly higher in patients with left ventricular hypertrophy (194.4 vs 152.9%, p=0.042) and diastolic dysfunction (180.5 vs 149.3%, p=0.031) than patients without these findings.


CONCLUSIONS
Among patients with acute ischemic stroke, FVIII levels were higher when there was evidence of hypertensive heart disease. Synthesis of FVIII may be augmented by the ongoing presence of shear stress and could contribute to the higher risk of vaso-occlusive events in patients with elevated FVIII.
Stroke Program, Department of Neurology, Tulane University Medical School, USA.
Joseph
J
Tarsia
Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, USA.
Tiffany R
TR
Chang
Services and Outcomes Research Center for Outcome and Effectiveness Research and Education (COERE), School of Medicine, University of Alabama at Birmingham, USA.
Aimee
A
Aysenne
Center of Excellence in Comparative Effectiveness Research for Eliminating Disparities (CERED) Minority Health & Health Disparities Research Center (MHRC), School of Medicine, University of Alabama at Birmingham, 35294.
Amelia K
AK
Boehme
Memorial Herman Hospital, USA.
Alton E
AE
Sartor
Stroke Program, Department of Neurology, University of Texas in Houston, USA.
Karen C
KC
Albright
Ethan Arda
EA
Yalvac
Rebecca
R
Kruse-Jarres
Cindy
C
Leissinger
Sheryl
S
Martin-Schild
Factor VIII; Hypertension; Hypertensive heart disease; Stroke