BACKGROUND AND PURPOSE: Patent foramen ovale (PFO) has been identified as a potential risk factor for cerebrovascular ischemia. Procoagulant mutations may increase the risk and impact the choice of appropriate therapy for secondary prevention. We evaluated the prevalence of the 2 most common genetic risk factors for thromboembolism, factor V Leiden (G1691A) and prothrombin G20210A, in young PFO patients who were referred for percutaneous transcatheter closure of their PFO. METHODS: Ninety-seven patients (50 men; mean+/-SD age, 40.9+/-10.0 years) with first-ever cerebrovascular events before the age of 55 years and 160 age-matched control subjects (69 men; mean+/-SD age, 40.4+/-10.5 years) were recruited into the study. Factor V Leiden and prothrombin G20210A mutations were detected by using a multiplex allele-specific polymerase chain reaction assay. RESULTS: The prevalence of subjects carrying at least 1 prothrombotic genotype was significantly higher in the group of PFO patients than in the group of controls (10.3% vs 2.5%; chi(2)=7.2, P=0.008). Two patients (2.1%) versus 1 control subject (0.6%) and 8 cases (8.2%) versus 3 controls (1.9%) were carriers for factor V Leiden and prothrombin G20210A mutations, respectively. After adjustment for other vascular risk factors, the combination of either factor V Leiden or prothrombin G20210A and PFO was associated with a 4.7-fold (95% CI=1.4 to 16.1; P=0.008) increased risk of cerebral ischemia in young patients. CONCLUSIONS: Our results indicate that prothrombotic mutations are important risk factors for cerebral ischemia in young patients with PFO. Screening for thrombotic mutations should be considered in young patients with PFO-related ischemic events.
BACKGROUND AND PURPOSE: Patent foramen ovale (PFO) has been identified as a potential risk factor for cerebrovascular ischemia. Procoagulant mutations may increase the risk and impact the choice of appropriate therapy for secondary prevention. We evaluated the prevalence of the 2 most common genetic risk factors for thromboembolism, factor V Leiden (G1691A) and prothrombin G20210A, in young PFO patients who were referred for percutaneous transcatheter closure of their PFO. METHODS: Ninety-seven patients (50 men; mean+/-SD age, 40.9+/-10.0 years) with first-ever cerebrovascular events before the age of 55 years and 160 age-matched control subjects (69 men; mean+/-SD age, 40.4+/-10.5 years) were recruited into the study. Factor V Leiden and prothrombin G20210A mutations were detected by using a multiplex allele-specific polymerase chain reaction assay. RESULTS: The prevalence of subjects carrying at least 1 prothrombotic genotype was significantly higher in the group of PFO patients than in the group of controls (10.3% vs 2.5%; chi(2)=7.2, P=0.008). Two patients (2.1%) versus 1 control subject (0.6%) and 8 cases (8.2%) versus 3 controls (1.9%) were carriers for factor V Leiden and prothrombin G20210A mutations, respectively. After adjustment for other vascular risk factors, the combination of either factor V Leiden or prothrombin G20210A and PFO was associated with a 4.7-fold (95% CI=1.4 to 16.1; P=0.008) increased risk of cerebral ischemia in young patients. CONCLUSIONS: Our results indicate that prothrombotic mutations are important risk factors for cerebral ischemia in young patients with PFO. Screening for thrombotic mutations should be considered in young patients with PFO-related ischemic events.
Authors: U Laufs; U C Hoppe; S Rosenkranz; P Kirchhof; M Böhm; H-C Diener; M Endres; M Grond; W Hacke; T Meinertz; E B Ringelstein; J Röther; M Dichgans Journal: Nervenarzt Date: 2010-04 Impact factor: 1.214
Authors: Lei Chen; Wenjun Deng; Igor Palacios; Ignacio Inglessis-Azuaje; David McMullin; Dong Zhou; Eng H Lo; Ferdinando Buonanno; MingMing Ning Journal: J Investig Med Date: 2016-03-17 Impact factor: 2.895
Authors: Domenico Consoli; Maurizio Paciaroni; Marco Aguggia; Maurizio Melis; Giovanni Malferrari; Simone Vidale; Paolo Cerrato; Simona Sacco; Carlo Gandolfo; Paolo Bovi; Carlo Serrati; Massimo Del Sette; Anna Cavallini; Marina Diomedi; Paolo Postorino; Stefano Ricci Journal: Neurol Sci Date: 2014-01-01 Impact factor: 3.307
Authors: Mingming Ning; Eng H Lo; Pei-Chen Ning; Su-Yu Xu; David McMullin; Zareh Demirjian; Ignacio Inglessis; G William Dec; Igor Palacios; Ferdinando S Buonanno Journal: Pharmacol Ther Date: 2013-03-23 Impact factor: 12.310