Background: It has been proposed that activated protein C resistance (APCR) due to the factor V Leiden (FVL) mutation may be a risk factor for stroke in young adults. However, this may not be the case for all ethnic groups due to variability in the prevalence of the FVL mutation.
Methods: Case series from a university neurology clinic. Patients with an APCR ratio of 2.2 or below were tested for the FVL mutation (nine patients). Patients on warfarin were also tested for the FVL mutation (14 patients).
Results: 38 African American patients under age 55 with an arterial stroke were identified. The mean age of the patients is 43.1 years. Five percent had an APCR ratio of 2.0 or below. None of the patients with an APCR ratio of 2.2 or below or the patients directly tested for the FVL mutation had the mutant allele.
Conclusions: Activated protein C resistance due to the FVL mutation does not appear to be a major risk factor for stroke in young African Americans. Other, as yet unidentified, mechanisms leading to activated protein C resistance may be important in a small subset of young African American stroke patients.