Diagnostic yield of prothrombotic state studies in cryptogenic stroke

Acta Neurol Scand. 2006 Oct;114(4):250-3. doi: 10.1111/j.1600-0404.2006.00588.x.

Abstract

Objectives: Around 30% of ischemic strokes are considered cryptogenic. We analyzed the diagnostic yield of prothrombotic state (PS) studies in patients with an initial cryptogenic stroke (CS).

Material and methods: We prospectively included consecutive CS patients according to the TOAST criteria. PS included plasmatic determinations of antiphospholipid (APL) antibodies and lupus anticoagulant (LA), S (SPd) and C (CPd) protein deficiencies, and genetic analysis of the prothrombin gene mutation (PT G20210A) and the factor V Leiden mutation (FV G1691A). We recorded age, sex and vascular risk factors.

Results: From a total of 89 patients (mean age 56.9 +/- 14.3 years, 53% men), we identified 16 PS in 15 patients (16.85%): APL-6, LA-2, SPd-2, CPd-1, PT G20210A -3 and FV G1691A -2. One patient presented an association (APL and PT G20210A).

Conclusions: One of every six patients with initial CS present a PS. Age or sex and conventional cardiovascular risk factors were not related to PS study findings, supporting the relevance of such studies in all patients with an initial CS.

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Antibodies, Antiphospholipid / blood
  • Blood Coagulation / genetics
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / genetics
  • Factor V / genetics
  • Female
  • Genetic Predisposition to Disease / genetics*
  • Humans
  • Lupus Coagulation Inhibitor / blood
  • Male
  • Middle Aged
  • Mutation / genetics*
  • Prospective Studies
  • Protein C / metabolism
  • Protein S / metabolism
  • Prothrombin / genetics
  • Risk Factors
  • Sex Distribution
  • Stroke / blood*
  • Stroke / diagnosis*
  • Stroke / etiology
  • Thrombosis / blood*
  • Thrombosis / diagnosis*
  • Thrombosis / genetics

Substances

  • Antibodies, Antiphospholipid
  • Lupus Coagulation Inhibitor
  • Protein C
  • Protein S
  • factor V Leiden
  • Factor V
  • Prothrombin