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Inherited thrombophilia in ischemic stroke and its pathogenic subtypes.

G J Hankey1, J W Eikelboom, F M van Bockxmeer

  • 1Stroke Unit, Department of Neurology, Royal Perth Hospital, Perth, Australia.

Stroke
|August 4, 2001
PubMed
Summary

Inherited thrombophilias are not a significant cause of ischemic stroke in most patients. Routine testing for these conditions in stroke patients is likely unnecessary, as the association appears coincidental.

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Area of Science:

  • Neurology
  • Genetics
  • Hematology

Background:

  • Inherited thrombophilias are suspected risk factors for ischemic stroke.
  • Few studies have investigated the link between thrombophilia and stroke subtypes.

Purpose of the Study:

  • To determine the association between inherited thrombophilias and first-ever ischemic stroke.
  • To explore this association across different pathogenic stroke subtypes.

Main Methods:

  • A case-control study involving 219 ischemic stroke patients and 205 community controls.
  • Assessed conventional vascular risk factors, plasma levels of protein C, S, antithrombin III, and genetic mutations (Factor V Leiden, prothrombin 20210A).
  • Stroke cases were classified by pathogenic subtype in a blinded manner.

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Main Results:

  • 14.7% of stroke cases and 11.7% of controls had a thrombophilia (OR 1.3, 95% CI 0.7-2.3).
  • Prevalence of individual thrombophilias varied, with antithrombin III deficiency being most common in cases (5.2%).
  • No significant differences in thrombophilia prevalence were found between cases and controls, or across stroke subtypes.

Conclusions:

  • While 1 in 7 ischemic stroke patients have an inherited thrombophilia, the link is likely coincidental, not causal.
  • Routine thrombophilia screening for most ischemic stroke patients is not recommended.
  • The role of thrombophilias in younger patients or for predicting stroke outcomes requires further investigation.