title: Thrombophilia testing in young patients with ischemic stroke.
abstract: BACKGROUND
  The possible significance of thrombophilia in ischemic stroke remains controversial. We aimed to study inherited and acquired thrombophilias as risk factors for ischemic stroke, transient ischemic attack (TIA) and amaurosis fugax in young patients.
  
  
  METHODS
  We included patients aged 18 to 50 years with ischemic stroke, TIA or amaurosis fugax referred to thrombophilia investigation at Aarhus University Hospital, Denmark from 1 January 2004 to 31 December 2012 (N=685). Clinical information was obtained from the Danish Stroke Registry and medical records. Thrombophilia investigation results were obtained from the laboratory information system. Absolute thrombophilia prevalences and associated odds ratios (OR) with 95% confidence intervals (95% CI) were reported for ischemic stroke (N=377) and TIA or amaurosis fugax (N=308). Thrombophilia prevalences for the general population were obtained from published data.
  
  
  RESULTS
  No strong associations were found between thrombophilia and ischemic stroke, but patients with persistent presence of lupus anticoagulant (3%) had an OR at 2.66 (95% CI 0.84-9.15) for ischemic stroke. A significantly higher risk of TIA/amaurosis fugax was found for factor V Leiden heterozygote (12%) (OR: 1.99 (95% CI 1.14-3.28)). No other inherited or acquired thrombophilia was associated with ischemic stroke, TIA or amaurosis fugax.
  
  
  CONCLUSIONS
  In young patients, thrombophilia did not infer an increased risk of ischemic stroke. Only factor V Leiden heterozygote patients had an increased risk of TIA/amaurosis fugax, and persistent presence of lupus anticoagulant was likely associated with ischemic stroke. We suggest the testing restricted to investigation of persistent presence of lupus anticoagulant.
authors.affiliation: Center for Hemophilia and Thrombosis, Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Sidse Høst
authors.initials: SH
authors.lastname: Pahus
authors.affiliation: Center for Hemophilia and Thrombosis, Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Anette Tarp
authors.initials: AT
authors.lastname: Hansen
authors.affiliation: Center for Hemophilia and Thrombosis, Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark. Electronic address: am.hvas@dadlnet.dk.
authors.forename: Anne-Mette
authors.initials: AM
authors.lastname: Hvas
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D015415:Biomarkers / Q000097:blood; D015984:Causality; D015897:Comorbidity; D003718:Denmark / Q000453:epidemiology; D005165:Factor V / Q000032:analysis*; D005260:Female; D006801:Humans; D016682:Lupus Coagulation Inhibitor / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D019851:Thrombophilia / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D016682:Lupus Coagulation Inhibitor; C095381:factor V Leiden; D005165:Factor V
keywords: Amaurosis fugax; Ischemic stroke; Thrombophilia; Transient ischemic attack