Format

Send to

Choose Destination
J Thromb Haemost. 2015 Sep;13(9):1568-75. doi: 10.1111/jth.13045. Epub 2015 Aug 21.

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

Siegerink B1,2,3, Maino A1,4, Algra A1,5,6, Rosendaal FR1,2,7.

Author information

1
Department Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.
2
Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands.
3
Center for Stroke Research Berlin, Charité Universitätsmedizin, Berlin, Germany.
4
Angelo Bianchi Bonomi, Hemophilia and Thrombosis Center, Fondazione IRCCS Cá Granda Ospedale Maggiore Policlinico, Milano, Italy.
5
Brain Center Rudolph Magnus, Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht, the Netherlands.
6
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
7
Departments of Neurology and Neurosurgery of Thrombosis and Haemostasis, Leiden University Medical Center, Leiden, the Netherlands.

Abstract

BACKGROUND:

Myocardial infarction (MI) and ischemic stroke (IS) are acute forms of arterial thrombosis and share some, but not all, risk factors, indicating different pathophysiological mechanisms.

OBJECTIVE:

This study aims to determine if hypercoagulability has a differential effect on the risk of MI and IS.

PATIENTS AND METHODS:

We reviewed the results from the Risk of Arterial Thrombosis in Relation to Oral Contraceptives study, a population-based case-control study involving young women (< 50 years) with MI, non-cardioembolic IS and healthy controls. From these data, relative odds ratios (ORIS /ORMI ) and their corresponding confidence intervals for all prothrombotic factors that were studied in both subgroups were calculated.

RESULTS:

Twenty-nine prothrombotic risk factors were identified as measures of hypercoagulability. Twenty-two of these risk factors (21/29, 72%) had a relative odds ratios > 1; for 12 (41%), it was > 2; and for 5 (17%), it was > 2.75. The five risk factors with the largest differences in associations were high levels of activated factor XI (FXI) and FXII, kallikrein, the presence of lupus anticoagulans, and a genetic variation in the FXIII gene.

CONCLUSION:

In young women, prothrombotic factors are associated more with the risk of IS than with MI risk, suggesting a different role of hypercoagulability in the mechanism leading to these two diseases.

KEYWORDS:

blood coagulation; hypercoagulability; myocardial infarction; stroke; women

PMID:
26178535
DOI:
10.1111/jth.13045
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center