title: Hypercoagulability and the risk of myocardial infarction and ischemic stroke in young women.
abstract: BACKGROUND
  Myocardial infarction (MI) and ischemic stroke (IS) are acute forms of arterial thrombosis and share some, but not all, risk factors, indicating different pathophysiological mechanisms.
  
  
  OBJECTIVE
  This study aims to determine if hypercoagulability has a differential effect on the risk of MI and IS.
  
  
  METHODS
  We reviewed the results from the Risk of Arterial Thrombosis in Relation to Oral Contraceptives study, a population-based case-control study involving young women (< 50 years) with MI, non-cardioembolic IS and healthy controls. From these data, relative odds ratios (ORIS /ORMI ) and their corresponding confidence intervals for all prothrombotic factors that were studied in both subgroups were calculated.
  
  
  RESULTS
  Twenty-nine prothrombotic risk factors were identified as measures of hypercoagulability. Twenty-two of these risk factors (21/29, 72%) had a relative odds ratios > 1; for 12 (41%), it was > 2; and for 5 (17%), it was > 2.75. The five risk factors with the largest differences in associations were high levels of activated factor XI (FXI) and FXII, kallikrein, the presence of lupus anticoagulans, and a genetic variation in the FXIII gene.
  
  
  CONCLUSIONS
  In young women, prothrombotic factors are associated more with the risk of IS than with MI risk, suggesting a different role of hypercoagulability in the mechanism leading to these two diseases.
authors.affiliation: Department Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.|Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands.|Center for Stroke Research Berlin, Charité Universitätsmedizin, Berlin, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Siegerink
authors.affiliation: Department Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.|Angelo Bianchi Bonomi, Hemophilia and Thrombosis Center, Fondazione IRCCS Cá Granda Ospedale Maggiore Policlinico, Milano, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Maino
authors.affiliation: Department Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.|Brain Center Rudolph Magnus, Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht, the Netherlands.|Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Algra
authors.affiliation: Department Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.|Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands.|Departments of Neurology and Neurosurgery of Thrombosis and Haemostasis, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: F R
authors.initials: FR
authors.lastname: Rosendaal
mesh_terms: D000328:Adult; D000367:Age Factors; D002545:Brain Ischemia / Q000453:epidemiology* / Q000209:etiology; D016022:Case-Control Studies; D015897:Comorbidity; D016001:Confidence Intervals; D003276:Contraceptives, Oral / Q000009:adverse effects; D003920:Diabetes Mellitus / Q000453:epidemiology; D005176:Factor XIII / Q000235:genetics; D015956:Factor XIIa / Q000032:analysis; D015945:Factor XIa / Q000032:analysis; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D007610:Kallikreins / Q000032:analysis; D016682:Lupus Coagulation Inhibitor / Q000097:blood; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000209:etiology; D009426:Netherlands / Q000453:epidemiology; D016017:Odds Ratio; D012306:Risk; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D019851:Thrombophilia / Q000097:blood / Q000139:chemically induced / Q000150:complications / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D003276:Contraceptives, Oral; D016682:Lupus Coagulation Inhibitor; D005176:Factor XIII; D007610:Kallikreins; D015945:Factor XIa; D015956:Factor XIIa
keywords: blood coagulation; hypercoagulability; myocardial infarction; stroke; women