Hypercoagulability and the risk of myocardial infarction and ischemic stroke in young women (July, 2015)
Abstract
BACKGROUND:
Myocardial infarction (MI) and ischemic stroke (IS) are both 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.
PATIENT & METHODS:
We reviewed the results from the RATIO 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, 12 (41%) >2, and 5 (17%) > 2.75. The five risk factors with the largest differences in associations were high levels of activated FXI and FXII, kallikrein, the presence of lupus anticoagulans, and a genetic variation in the factor XIII gene.
CONCLUSION:
In young women, prothrombotic factors are more associated with risk of IS than MI risk, suggesting a different role of hypercoagulability in the mechanism leading to these two diseases. This article is protected by copyright. All rights reserved.
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