Department of Neurology, University of Maryland School of Medicine, Baltimore, Maryland 21201-1509, USA.
J Stroke Cerebrovasc Dis. 2013 May;22(4):419-23. doi: 10.1016/j.jstrokecerebrovasdis.2011.10.007. Epub 2011 Nov 18.
Factor V Leiden (FVL) has been associated with ischemic stroke in children but not in adults. Although the FVL mutation is associated with increased risk for venous thrombosis, its association with ischemic stroke in young adults remains uncertain. Therefore, we examined the association between FVL and ischemic stroke in participants of the Genetics of Early Onset Stroke (GEOS) study.
A population-based case control study identified 354 women and 476 men 15 to 49 years of age with first-ever ischemic stroke and 907 controls. Participant-specific data included vascular risk factors, FVL genotype and, for cases, the ischemic stroke subtype by modified Trial of ORG 10172 in Acute Stroke criteria. Logistic regression was used to calculate odds ratios for the entire population and for subgroups stratified by risk factors and ischemic stroke subtype.
The frequency of the FVL mutation was similar between ischemic stroke patients (3.6%; 95% confidence interval [CI] 2.5%-5.1%) and nonstroke controls (3.8%; 95% CI 2.7%-5.2%). This frequency did not change significantly when cases were restricted to patients with stroke of undetermined etiology (4.1%; 95% CI 2.6%-6.4%).
Among young adults, we found no evidence for an association between FVL and either all ischemic stroke or the subgroup with stroke of undetermined etiology.
因子 V 莱顿突变(FVL)与儿童缺血性脑卒中有关,但与成年人无关。尽管 FVL 突变与静脉血栓形成的风险增加有关,但它与年轻成年人缺血性脑卒中的关系仍不确定。因此,我们研究了遗传学早期发病脑卒中研究(GEOS)中的 FVL 与缺血性脑卒中之间的关联。
一项基于人群的病例对照研究确定了 354 名年龄在 15 至 49 岁之间的首次发生缺血性脑卒中的女性和 476 名男性病例以及 907 名对照。参与者特定的数据包括血管危险因素、FVL 基因型,以及病例组按改良的 ORG 10172 在急性脑卒中试验标准的缺血性脑卒中亚型。采用逻辑回归计算整个人群和按危险因素和缺血性脑卒中亚型分层的亚组的比值比。
缺血性脑卒中患者(3.6%;95%置信区间[CI] 2.5%-5.1%)和非脑卒中对照组(3.8%;95% CI 2.7%-5.2%)之间 FVL 突变的频率相似。当病例仅限于病因不明的脑卒中患者(4.1%;95% CI 2.6%-6.4%)时,这种频率没有显著变化。
在年轻成年人中,我们没有发现 FVL 与所有缺血性脑卒中或病因不明的脑卒中亚组之间存在关联的证据。