Frontiers in Cardiovascular Medicine (Jun 2017)

A Prothrombotic Score Based on Genetic Polymorphisms of the Hemostatic System Differs in Patients with Ischemic Stroke, Myocardial Infarction, or Peripheral Arterial Occlusive Disease

  • Juliane Herm,
  • Juliane Herm,
  • Berthold Hoppe,
  • Berthold Hoppe,
  • Bob Siegerink,
  • Christian H. Nolte,
  • Christian H. Nolte,
  • Christian H. Nolte,
  • Jürgen Koscielny,
  • Karl Georg Haeusler,
  • Karl Georg Haeusler

DOI
https://doi.org/10.3389/fcvm.2017.00039
Journal volume & issue
Vol. 4

Abstract

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BackgroundWhile twin studies indicate a genetic component in arterial thrombosis such as ischemic stroke, myocardial infarction (MI), or peripheral arterial occlusive disease (PAOD), the clinical relevance of hemostatic polymorphisms in arterial thrombosis is a matter of debate.MethodsWe analyzed the prevalence of 13 hemostatic polymorphisms [PAI-1, PLAT, F5 (including factor V Leiden and HR2 haplotype), F2, F7, F13A, FGB, TFPI, THBD, MTHFR, ACE, and ITGA2] in patients referred to a tertiary referral center. A “prothrombotic score” was calculated by dividing the number of risk-increasing polymorphisms for thrombosis minus the number of risk-lowering polymorphisms (F7 and F13A) by the number of polymorphisms tested.ResultsDatasets of 144 patients with prior ischemic stroke (mean age 44 ± 13 years; 65% female) were compared to 62 patients with MI or PAOD (mean age 54 ± 14 years; 47% female). The prothrombotic score was lower in MI and PAOD patients compared to stroke patients [odds ratios 2.7 (95% confidence intervals 1.1–6.2)]. Frequencies of individual polymorphisms did not differ between both groups.ConclusionPatients with MI or PAOD had a lower burden of prothrombotic mutations compared to patients with prior stroke, indicating that a prothrombotic state might play a different role in distinct forms of arterial thrombosis.

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