Abstract |
Hereditary thrombophilias are a heterogenous group of genetic coagulation disorders which, particularly in combination with acquired prothrombotic factors, induce a predisposition to thrombosis. After characterization of frequent thrombophilic syndromes like factor V-Leiden or the prothrombin 20210GA mutation, a number of case-control studies screened for the prevalence of these mutations in ischemic stroke and cerebral venous thrombosis (CVT). Our meta-analysis shows that factor V-Leiden and prothrombin are frequent and significantly associated with CVT (16.4% vs. 4.9% or 4.3, P < 0.001, and 12.1% vs. 1.9% or 5.8, P < 0.001). In ischemic stroke, only factor V-Leiden and not prothrombin is a weak but significant risk factor (5.9% vs. 2.6% or 1.6, P < 0.001, and 4.1% vs. 3.3% or 1.4, P = 0.1). The C677T homozygous point mutation in the MTHFR, a homocysteine-degrading enzyme, was also associated with arterial stroke (16% vs. 15% or 1.5, P < 0.001). For CVT, sufficient data are lacking. We therefore recommend screening for thrombophilia in CVT. In ischemic stroke, atrial premature complex ( APC) resistance should be considered. As long as controlled studies are lacking, individual anticoagulant therapy must take hereditary and precipitating factors into account to assess potential thrombotic risk.
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Authors | M Weih, J Junge-Hülsing, S Mehraein, S Ziemer, K M Einhäupl |
Journal | Der Nervenarzt
(Nervenarzt)
Vol. 71
Issue 12
Pg. 936-45
(Dec 2000)
ISSN: 0028-2804 [Print] Germany |
Vernacular Title | Hereditäre Thrombophilien bei ischämischem Schlaganfall und Sinusvenenthrombosen. Diagnostik, Therapie und Meta-Analyse. |
PMID | 11139989
(Publication Type: English Abstract, Journal Article, Meta-Analysis)
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Topics |
- Cerebral Infarction
(diagnosis, genetics, therapy)
- Diagnosis, Differential
- Genetic Testing
- Humans
- Risk Factors
- Sinus Thrombosis, Intracranial
(genetics, therapy)
- Thrombophilia
(diagnosis, genetics, therapy)
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