Gouse Brittany M, Boehme Amelia K, Monlezun Dominique J, Siegler James E, George Alex J, Brag Katherine, Albright Karen C, Beasley T Mark, Leissinger Cindy, El Khoury Ramy, Martin-Schild Sheryl
Stroke Program, Department of Neurology, Tulane University School of Medicine, 1440 Canal Street, TB-52, Suite 1000, New Orleans, LA 70112-2715, USA.
Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, 630 West 168 Street, New York, NY 10032, USA.
Thrombosis. 2014;2014:302861. doi: 10.1155/2014/302861. Epub 2014 Dec 17.
Background. Heightened levels of Factor VIII (FVIII) have been associated with both arterial and venous thrombosis. While elevated FVIII is common during acute ischemic stroke (AIS), whether elevated FVIII confers an increased risk for recurrent thrombotic events (RTEs) following AIS has not been previously explored. Methods. Consecutive AIS patients who presented to our center between July 2008 and September 2013 and had FVIII measured during admission were identified from our stroke registry. Baseline characteristics and the occurrence of RTE (recurrent or progressive ischemic stroke, DVT/PE, and MI) were compared in patients with and without elevated FVIII levels. Results. Of the 298 patients included, 203 (68.1%) had elevated FVIII levels. Patients with elevated FVIII had higher rates of any in-hospital RTE (18.7% versus 8.4%, P = 0.0218). This association remained after adjustment for baseline stroke severity and etiology (OR 1.01, 95% CI 1.00-1.01, P = 0.0013). Rates of major disability were also higher in patients who experienced a RTE (17.8% versus 3.2%, P < 0.0001). Conclusion. A significantly higher frequency of in-hospital RTEs occurred in AIS patients with elevated FVIII. The occurrence of such events was associated with higher morbidity. Further study is indicated to evaluate whether FVIII is a candidate biomarker for increased risk of RTEs following AIS.
背景。凝血因子VIII（FVIII）水平升高与动脉和静脉血栓形成均有关联。虽然FVIII水平升高在急性缺血性卒中（AIS）期间很常见，但此前尚未探讨FVIII水平升高是否会增加AIS后复发性血栓事件（RTE）的风险。方法。从我们的卒中登记处识别出2008年7月至2013年9月期间在我们中心就诊且入院时检测了FVIII的连续AIS患者。比较FVIII水平升高和未升高的患者的基线特征以及RTE（复发性或进展性缺血性卒中、深静脉血栓形成/肺栓塞和心肌梗死）的发生情况。结果。在纳入的298例患者中，203例（68.1%）FVIII水平升高。FVIII水平升高的患者发生任何院内RTE的比率更高（18.7%对8.4%，P = 0.0218）。在对基线卒中严重程度和病因进行调整后，这种关联仍然存在（OR 1.01，95%CI 1.00 - 1.01，P = 0.0013）。发生RTE的患者中重度残疾的比率也更高（17.8%对3.2%，P < 0.0001）。结论。FVIII水平升高的AIS患者院内RTE的发生频率显著更高。此类事件的发生与更高的发病率相关。有必要进一步研究以评估FVIII是否是AIS后RTE风险增加的候选生物标志物。
