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Hypercoagulability and the risk of myocardial infarction and ischemic stroke in young women

B Siegerink1,2,3, A Maino1,4, A Algra1,5,6

  • 1Department Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.

Journal of Thrombosis and Haemostasis : JTH
|July 17, 2015
PubMed

Insights

Prothrombotic factors, indicators of hypercoagulability, are more strongly linked to ischemic stroke (IS) risk than myocardial infarction (MI) risk in young women. This suggests distinct hypercoagulability roles in the development of these arterial thrombotic events.

Area of Science:

  • Cardiovascular Medicine
  • Hematology
  • Thrombosis Research

Background:

  • Myocardial infarction (MI) and ischemic stroke (IS) are acute arterial thrombotic events with partially overlapping risk factors.
  • Distinct pathophysiological mechanisms underlie MI and IS, necessitating investigation into differential risk factor associations.

Purpose of the Study:

  • To investigate whether hypercoagulability differentially impacts the risk of MI versus IS.
  • To identify specific prothrombotic factors associated with increased risk for either MI or IS.

Main Methods:

  • Analysis of a population-based case-control study (Risk of Arterial Thrombosis in Relation to Oral Contraceptives) involving young women (<50 years).
  • Comparison of relative odds ratios (ORIS/ORMI) and confidence intervals for 29 identified prothrombotic factors in women with MI, non-cardioembolic IS, and healthy controls.

Main Results:

  • Seventy-two percent (21/29) of hypercoagulability measures showed increased odds ratios for arterial thrombosis.
  • Twelve factors (41%) demonstrated odds ratios greater than 2, and five factors (17%) exceeded 2.75.
  • Activated factor XI (FXI) and FXII, kallikrein, lupus anticoagulans, and FXIII gene variation showed the most significant differential associations.

Conclusions:

  • Prothrombotic factors are more strongly associated with ischemic stroke risk than myocardial infarction risk in young women.
  • These findings suggest a differential role of hypercoagulability in the pathogenesis of IS compared to MI.
Abstract

Keywords:
blood coagulationhypercoagulabilitymyocardial infarctionstrokewomen

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