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Factor XIII A-subunit concentration predicts outcome in stroke subjects and vascular outcome in healthy, middle-aged

Hans P Kohler1, Robert A S Ariëns, Andrew J Catto

  • 1Unit of Molecular Vascular Medicine, Leeds General Infirmary, University of Leeds, UK. hanspeter.kohler@insel.ch

British Journal of Haematology
|August 16, 2002
PubMed

Insights

Low levels of factor XIII (FXIII) are linked to increased risk of myocardial infarction and stroke. Reduced FXIII A-subunit antigen predicts poor vascular outcomes and survival in patients with acute ischemic stroke.

Area of Science:

  • Cardiovascular Science
  • Hematology
  • Thrombosis Research

Background:

  • Factor XIII (FXIII) plays a critical role in hemostasis and wound healing.
  • Growing evidence suggests a link between FXIII and vascular diseases, including myocardial infarction and stroke.
  • Understanding FXIII's role in thrombotic events is crucial for developing preventative strategies.

Purpose of the Study:

  • To investigate the association between factor XIII (FXIII) levels and vascular disease outcomes.
  • To determine if FXIII A- and B-subunit antigen levels and activity predict myocardial infarction (MI) and stroke.
  • To explore the relationship between FXIII levels, thrombin generation, and thrombotic risk.

Main Methods:

  • Nested case-control study (Second Northwick Park Heart Study) of men with MI and controls.
  • Case-control study of acute stroke patients and controls, with follow-up for mortality.
  • Measurement of FXIII A- and B-subunit antigen, FXIII activity, and prothrombin fragments (F1 + 2).
  • In vitro model to assess thrombin activity effects on FXIII antigen levels.

Main Results:

  • Lower FXIII A-subunit levels were observed in men who later developed MI compared to controls.
  • Stroke patients with large vessel disease had lower FXIII A-subunit antigen and higher prothrombin fragments (F1 + 2) than those with small vessel disease.
  • Lower FXIII A-subunit and higher F1 + 2 levels were associated with mortality in stroke patients.
  • Low FXIII A-subunit antigen predicted vascular outcomes and related to infarct size and post-stroke survival.

Conclusions:

  • Low factor XIII (FXIII) A-subunit antigen concentrations are a predictor of vascular outcomes in healthy individuals.
  • Reduced FXIII A-subunit levels are associated with increased risk of thrombotic events, potentially due to increased thrombin generation.
  • These findings highlight FXIII's significant role in the pathogenesis of vascular diseases and suggest its potential as a biomarker.

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