Inherited Thrombophilia as a Risk Factor for the Development of Ischemic Stroke in Young Adults

Barbara Voetsch; Benito P. Damasceno; Erica C. S. Camargo; Ayrton Massaro; Luiz A. Bacheschi; Milberto Scaff; Joyce M. Annichino-Bizzacchi; Valder R. Arruda

doi:10.1055/s-0037-1613791

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 2000; 83(02): 229-233
DOI: 10.1055/s-0037-1613791

Rapid Communication

Schattauer GmbH

Inherited Thrombophilia as a Risk Factor for the Development of Ischemic Stroke in Young Adults

Barbara Voetsch

¹From the Department of Neurology, São Paulo, Brazil

,

Benito P. Damasceno

¹From the Department of Neurology, São Paulo, Brazil

,

Erica C. S. Camargo

³Department of Neurology, University of São Paulo, São Paulo, Brazil

,

Ayrton Massaro

³Department of Neurology, University of São Paulo, São Paulo, Brazil

,

Luiz A. Bacheschi

³Department of Neurology, University of São Paulo, São Paulo, Brazil

,

Milberto Scaff

³Department of Neurology, University of São Paulo, São Paulo, Brazil

,

Joyce M. Annichino-Bizzacchi

²Hematology-Hemotherapy Center, State University of Campinas, Campinas, São Paulo, Brazil, São Paulo, Brazil

,

Valder R. Arruda

²Hematology-Hemotherapy Center, State University of Campinas, Campinas, São Paulo, Brazil, São Paulo, Brazil

› Institutsangaben

Abstract

Summary

Introduction

Several recent studies have analyzed a possible effect of thrombophilia risk factors such as factor V Leiden, the prothrombin variant (allele 20210 A), and homozygosity for thermolabile methylenetetrahydrofolate reductase (MTHFR-T) on the development of ischemic stroke (IS). In the present study, we determined the role of these prothrombotic polymorphisms in the early onset of arterial IS or cerebral venous thrombosis (CVT) in a group of young Brazilian adults of Caucasian and African descent.

Materials and Methods

We conducted a cross-sectional study of 167 survivors of IS (153 patients with arterial IS and 14 cases of CVT; 66 men: 101 women; 124 of Caucasian and 43 of African origin; median age: 32.6 years; range: 15 to 45 years) and compared the prevalence of inherited thrombophilia risk factors with a control group of 225 sex and age matched individuals of the same ethnic background. To determine the interaction with atherogenic risk factors, the following diagnoses were considered: hypertension, hyperlipoproteinemia, diabetes mellitus, smoking status and use of oral contraceptives.

Results

In the arterial IS group, no significant variation was found between patients and controls of Caucasian origin regarding the prevalence of factor V Leiden (P = 0.92), the prothrombin variant (P = 0.13) or homozygosity for MTHFR-T (P = 0.61). Among Brazilians of African descent, 10.3%were homozygous for MTHFR-T, which was significantly elevated, odds ratio of 5.9 (95%CI: 0.88 to 49.15). In the CVT group, two Caucasian patients (20%) were heterozygous for the prothrombin variant, odds ratio of 9.7 (95%CI: 0.95 to 89.71) and one patient was carrier of factor V Leiden (P = 0.49). No prothrombotic polymorphism was identified in patients with CVT of African descent. All women in the CVT group were in use of oral contraceptives or in the post-partum state

Discussion

Inherited thrombophilia risk factors were not found to increase the risk of arterial IS among young patients of Caucasian descent. However, a potential role of homozygosity for MTHFR-T was observed in a small group of patients of African origin. The analysis of patients with CVT revealed an increased risk due to the prothrombin gene variant or oral contraceptive use. Further studies including all incoming patients with IS are necessary to evaluate the impact of inherited thrombophilia risk factors on early mortality.

Keywords

Thrombophilia - stroke - venous thrombosis

Volltext

Referenzen

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