Thrombophilic screening in young patients (<40 years) with idiopathic ischemic stroke: A controlled study

Francesco Dragoni, Flavia Chiarotti, Giuseppe Rosano, Paolo Simioni, Daniela Tormene, Maria Gabriella Mazzucconi, Arturo Cafolla, Giuseppe Avvisati

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Introduction: Despite extensive clinical and laboratory investigations, the etiology of ischemic stroke remains unknown in approximately one third of patients. Materials and Methods: Thirty-four consecutive patients less than 40 years old (Males 13, Females 21, mean age 26.6 years, range 2-39) with documented ischemic stroke underwent, one year after the acute event, laboratory evaluation of antithrombin, protein C, free and total protein S, activated protein C resistance, fibrinogen, factor VII:C, homocysteine levels and antiphospholipid antibodies (APA). Moreover, prevalence of F5 R506Q, F2 G2021A and homozygosis for thermolabile variant C677T of the methylenetetrahydrofolate reductase (MTHFR) were also evaluated and compared to the results obtained in 120 normal controls. Results: Antithrombin and protein C levels resulted normal in all cases. One patient (2.9%) showed free protein S deficiency and 3 patients (8.8%) had activated protein C resistance. Homocysteine levels above 15 μmol/L were found in one patient (2.9%). APA were found in 21 patients (61.7%) and in only 2 out of 120 (1.66%) controls (OR = 95.31; 95% C.I.: 18.22-667.81). The multivariate analysis selected that the presence of APA was significantly associated with an increased risk of stroke (OR = 156.60; 95% C.I.: 25.99-943.47) in this cohort of patients. The combination between APA and cardiovascular risk factors determined a risk of 29-fold (OR = 29.31; 95% CI: 3.28-261.69). Discussion: Our data suggest that the presence of APA is associated with an increased risk of idiopathic ischemic stroke in young patients. Furthermore, also the combination of APA and cardiovascular risk factors is significantly associated with development of idiopathic ischemic stroke.

Original languageEnglish
Pages (from-to)85-90
Number of pages6
JournalThrombosis Research
Volume127
Issue number2
DOIs
Publication statusPublished - Feb 2011

Fingerprint

Antiphospholipid Antibodies
Stroke
Antithrombin Proteins
Activated Protein C Resistance
Homocysteine
Protein C
Protein S Deficiency
Methylenetetrahydrofolate Reductase (NADPH2)
Factor VII
R Factors
Protein S
Fibrinogen
Multivariate Analysis

Keywords

  • Antiphospholipid antibodies
  • Ischemic stroke
  • Thrombophilic screening
  • Young patients

ASJC Scopus subject areas

  • Hematology

Cite this

Thrombophilic screening in young patients (<40 years) with idiopathic ischemic stroke : A controlled study. / Dragoni, Francesco; Chiarotti, Flavia; Rosano, Giuseppe; Simioni, Paolo; Tormene, Daniela; Mazzucconi, Maria Gabriella; Cafolla, Arturo; Avvisati, Giuseppe.

In: Thrombosis Research, Vol. 127, No. 2, 02.2011, p. 85-90.

Research output: Contribution to journalArticle

Dragoni, F, Chiarotti, F, Rosano, G, Simioni, P, Tormene, D, Mazzucconi, MG, Cafolla, A & Avvisati, G 2011, 'Thrombophilic screening in young patients (<40 years) with idiopathic ischemic stroke: A controlled study', Thrombosis Research, vol. 127, no. 2, pp. 85-90. https://doi.org/10.1016/j.thromres.2010.11.013
Dragoni, Francesco ; Chiarotti, Flavia ; Rosano, Giuseppe ; Simioni, Paolo ; Tormene, Daniela ; Mazzucconi, Maria Gabriella ; Cafolla, Arturo ; Avvisati, Giuseppe. / Thrombophilic screening in young patients (<40 years) with idiopathic ischemic stroke : A controlled study. In: Thrombosis Research. 2011 ; Vol. 127, No. 2. pp. 85-90.
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abstract = "Introduction: Despite extensive clinical and laboratory investigations, the etiology of ischemic stroke remains unknown in approximately one third of patients. Materials and Methods: Thirty-four consecutive patients less than 40 years old (Males 13, Females 21, mean age 26.6 years, range 2-39) with documented ischemic stroke underwent, one year after the acute event, laboratory evaluation of antithrombin, protein C, free and total protein S, activated protein C resistance, fibrinogen, factor VII:C, homocysteine levels and antiphospholipid antibodies (APA). Moreover, prevalence of F5 R506Q, F2 G2021A and homozygosis for thermolabile variant C677T of the methylenetetrahydrofolate reductase (MTHFR) were also evaluated and compared to the results obtained in 120 normal controls. Results: Antithrombin and protein C levels resulted normal in all cases. One patient (2.9{\%}) showed free protein S deficiency and 3 patients (8.8{\%}) had activated protein C resistance. Homocysteine levels above 15 μmol/L were found in one patient (2.9{\%}). APA were found in 21 patients (61.7{\%}) and in only 2 out of 120 (1.66{\%}) controls (OR = 95.31; 95{\%} C.I.: 18.22-667.81). The multivariate analysis selected that the presence of APA was significantly associated with an increased risk of stroke (OR = 156.60; 95{\%} C.I.: 25.99-943.47) in this cohort of patients. The combination between APA and cardiovascular risk factors determined a risk of 29-fold (OR = 29.31; 95{\%} CI: 3.28-261.69). Discussion: Our data suggest that the presence of APA is associated with an increased risk of idiopathic ischemic stroke in young patients. Furthermore, also the combination of APA and cardiovascular risk factors is significantly associated with development of idiopathic ischemic stroke.",
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AU - Dragoni, Francesco

AU - Chiarotti, Flavia

AU - Rosano, Giuseppe

AU - Simioni, Paolo

AU - Tormene, Daniela

AU - Mazzucconi, Maria Gabriella

AU - Cafolla, Arturo

AU - Avvisati, Giuseppe

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N2 - Introduction: Despite extensive clinical and laboratory investigations, the etiology of ischemic stroke remains unknown in approximately one third of patients. Materials and Methods: Thirty-four consecutive patients less than 40 years old (Males 13, Females 21, mean age 26.6 years, range 2-39) with documented ischemic stroke underwent, one year after the acute event, laboratory evaluation of antithrombin, protein C, free and total protein S, activated protein C resistance, fibrinogen, factor VII:C, homocysteine levels and antiphospholipid antibodies (APA). Moreover, prevalence of F5 R506Q, F2 G2021A and homozygosis for thermolabile variant C677T of the methylenetetrahydrofolate reductase (MTHFR) were also evaluated and compared to the results obtained in 120 normal controls. Results: Antithrombin and protein C levels resulted normal in all cases. One patient (2.9%) showed free protein S deficiency and 3 patients (8.8%) had activated protein C resistance. Homocysteine levels above 15 μmol/L were found in one patient (2.9%). APA were found in 21 patients (61.7%) and in only 2 out of 120 (1.66%) controls (OR = 95.31; 95% C.I.: 18.22-667.81). The multivariate analysis selected that the presence of APA was significantly associated with an increased risk of stroke (OR = 156.60; 95% C.I.: 25.99-943.47) in this cohort of patients. The combination between APA and cardiovascular risk factors determined a risk of 29-fold (OR = 29.31; 95% CI: 3.28-261.69). Discussion: Our data suggest that the presence of APA is associated with an increased risk of idiopathic ischemic stroke in young patients. Furthermore, also the combination of APA and cardiovascular risk factors is significantly associated with development of idiopathic ischemic stroke.

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KW - Thrombophilic screening

KW - Young patients

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