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Thrombophilic screening in young patients (<40years) with idiopathic ischemic stroke: A controlled study.
MedLine Citation:
PMID:  21172722     Owner:  NLM     Status:  In-Data-Review    
INTRODUCTION: Despite extensive clinical and laboratory investigations, the etiology of ischemic stroke remains unknown in approximately one third of patients.
MATERIALS AND METHODS: Thirty-four consecutive patients less than 40years old (Males 13, Females 21, mean age 26.6years, range 2-39) with documented ischemic stroke underwent, one year after the acute event, laboratory evaluation of antithrombin, protein C, free and total protein S, activated protein C resistance, fibrinogen, factor VII:C, homocysteine levels and antiphospholipid antibodies (APA). Moreover, prevalence of F5 R506Q, F2 G2021A and homozygosis for thermolabile variant C677T of the methylenetetrahydrofolate reductase (MTHFR) were also evaluated and compared to the results obtained in 120 normal controls.
RESULTS: Antithrombin and protein C levels resulted normal in all cases. One patient (2.9%) showed free protein S deficiency and 3 patients (8.8%) had activated protein C resistance. Homocysteine levels above 15μmol/L were found in one patient (2.9%). APA were found in 21 patients (61.7%) and in only 2 out of 120 (1.66%) controls (OR=95.31; 95% C.I.: 18.22-667.81). The multivariate analysis selected that the presence of APA was significantly associated with an increased risk of stroke (OR=156.60; 95% C.I.: 25.99-943.47) in this cohort of patients. The combination between APA and cardiovascular risk factors determined a risk of 29-fold (OR=29.31; 95% CI: 3.28-261.69).
DISCUSSION: Our data suggest that the presence of APA is associated with an increased risk of idiopathic ischemic stroke in young patients. Furthermore, also the combination of APA and cardiovascular risk factors is significantly associated with development of idiopathic ischemic stroke.
Francesco Dragoni; Flavia Chiarotti; Giuseppe Rosano; Paolo Simioni; Daniela Tormene; Maria Gabriella Mazzucconi; Arturo Cafolla; Giuseppe Avvisati
Publication Detail:
Type:  Journal Article     Date:  2010-12-18
Journal Detail:
Title:  Thrombosis research     Volume:  127     ISSN:  1879-2472     ISO Abbreviation:  Thromb. Res.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0326377     Medline TA:  Thromb Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  85-90     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Ltd. All rights reserved.
Thrombosis Center, Department of "Biotecnologie Cellulari ed Ematologia", University "Sapienza", Rome, Italy.
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