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A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis
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A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis

Published on: August 12, 2025

Thrombophilic risk factors in patients with severe carotid atherosclerosis

R Marcucci1, F Sofi, S Fedi

  • 1Thrombosis Center, University of Florence, Dipartimento del Cuore e dei Vasi, Center for the Study at Molecular and Clinical Level of Chronic, Degenerative and Neoplastic Diseases to Develop Novel Therapies, Firenze, Italy. r.marcucci@dac.unifi.it

Journal of Thrombosis and Haemostasis : JTH
|March 8, 2005
PubMed

Insights

Elevated homocysteine, lipoprotein(a), anticardiolipin antibodies, and specific genetic factors increase the risk of severe carotid stenosis. These thrombophilic factors are more prevalent in patients with carotid atherosclerosis.

Area of Science:

  • Cardiovascular Medicine
  • Genetics
  • Thrombosis

Background:

  • Carotid stenosis and atrial fibrillation are primary risk factors for ischemic stroke.
  • Identifying novel risk factors for carotid atherosclerosis is crucial for stroke prevention.
  • Thrombophilic factors play a significant role in the development of atherosclerosis.

Purpose of the Study:

  • To determine the thrombophilic risk profile in patients with severe carotid stenosis.
  • To evaluate genetic and metabolic risk factors associated with carotid atherosclerosis.
  • To identify independent risk factors for severe carotid stenosis in men and women.

Main Methods:

  • Case-control study comparing 615 patients with severe carotid stenosis to 615 healthy controls.
  • Evaluation of genetic factors: Factor (F)II G20210A, Factor V Leiden, MTHFR C677T polymorphisms.
  • Assessment of metabolic factors: anticardiolipin antibodies (aCL), lipoprotein(a) (Lp(a)), and homocysteine (Hcy).

Main Results:

  • Independent risk factors for severe carotid stenosis included elevated Hcy (OR 7.6), Lp(a) (OR 2.9), aCL (OR 5.7), and FII G20210A heterozygosity (OR 2.8).
  • In women, independent risk factors were high Hcy, Lp(a), and aCL.
  • In men, independent risk factors included hyperhomocysteinemia, elevated Lp(a), aCL, FII G20210A, and MTHFR 677TT polymorphisms.

Conclusions:

  • The prevalence of thrombophilic risk factors is significantly increased in patients with severe carotid atherosclerosis.
  • Specific thrombophilic factors contribute independently to the risk of severe carotid stenosis.
  • Risk factor profiles differ between men and women with severe carotid atherosclerosis.

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