BACKGROUND/AIM: Prognosis and optimal secondary prevention in ischemic stroke patients with coagulopathies remain unclear. The goal of this prospective observational multicenter study was to determine the risk of recurrence in cryptogenic stroke patients with either no or defined coagulopathies under various prevention regimens. METHODS: A total of 429 patients from 14 German stroke centers with an acute cryptogenic ischemic stroke or transient ischemic attack in whom specialized coagulation testing for inherited and acquired coagulopathies (factor V Leiden mutation/resistance to activated protein C, prothrombin mutation, deficiencies of protein C, protein S, antithrombin III, anticardiolipin IgG antibodies, lupus anticoagulant) had been performed were included. Biannual follow-up in 339 (79%) of these patients assessed recurrent cerebrovascular events and secondary prevention therapy during a mean period of 2.5 years. RESULTS: A defined coagulopathy was detected in 89 patients with follow-up, whereas no coagulopathy could be found in 250 patients with follow-up (control group). The Kaplan-Meier estimate for recurrent ischemic stroke or transient ischemic attack after 3 years was 13.6% (95% CI: 5.9-21.2%) in patients with a coagulopathy compared to 9.3% (95% CI: 5.4-13.2%) in controls, which was not significant after adjustment for potential risk factors by Cox regression analysis. Only a previous cerebrovascular ischemic event was an independent predictor for risk of recurrence in coagulopathy and control patients. CONCLUSIONS: Our observational data do not indicate a significantly increased risk for recurrent cerebrovascular events in cryptogenic stroke patients with a coagulopathy or any significant influence of the type of antithrombotic treatment. Copyright (c) 2009 S. Karger AG, Basel.
BACKGROUND/AIM: Prognosis and optimal secondary prevention in ischemic strokepatients with coagulopathies remain unclear. The goal of this prospective observational multicenter study was to determine the risk of recurrence in cryptogenic strokepatients with either no or defined coagulopathies under various prevention regimens. METHODS: A total of 429 patients from 14 German stroke centers with an acute cryptogenic ischemic stroke or transient ischemic attack in whom specialized coagulation testing for inherited and acquired coagulopathies (factor V Leiden mutation/resistance to activated protein C, prothrombin mutation, deficiencies of protein C, protein S, antithrombin III, anticardiolipin IgG antibodies, lupus anticoagulant) had been performed were included. Biannual follow-up in 339 (79%) of these patients assessed recurrent cerebrovascular events and secondary prevention therapy during a mean period of 2.5 years. RESULTS: A defined coagulopathy was detected in 89 patients with follow-up, whereas no coagulopathy could be found in 250 patients with follow-up (control group). The Kaplan-Meier estimate for recurrent ischemic stroke or transient ischemic attack after 3 years was 13.6% (95% CI: 5.9-21.2%) in patients with a coagulopathy compared to 9.3% (95% CI: 5.4-13.2%) in controls, which was not significant after adjustment for potential risk factors by Cox regression analysis. Only a previous cerebrovascular ischemic event was an independent predictor for risk of recurrence in coagulopathy and control patients. CONCLUSIONS: Our observational data do not indicate a significantly increased risk for recurrent cerebrovascular events in cryptogenic strokepatients with a coagulopathy or any significant influence of the type of antithrombotic treatment. Copyright (c) 2009 S. Karger AG, Basel.
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
Authors: Setareh S Omran; Michael P Lerario; Gino Gialdini; Alexander E Merkler; Antonio Moya; Monica L Chen; Hooman Kamel; Maria DeSancho; Babak B Navi Journal: J Stroke Cerebrovasc Dis Date: 2018-12-27 Impact factor: 2.136
Authors: Robert G Hart; Mukul Sharma; Hardi Mundl; Ashkan Shoamanesh; Scott E Kasner; Scott D Berkowitz; Guillaume Pare; Bodo Kirsch; Janice Pogue; Calin Pater; Gary Peters; Antoni Davalos; Wilfried Lang; Yongjun Wang; Yilong Wang; Luis Cunha; Jens Eckstein; Turgut Tatlisumak; Nikolay Shamalov; Robert Mikulik; Pablo Lavados; Graeme J Hankey; Anna Czlonkowska; Danilo Toni; Sebastian F Ameriso; Rubens J Gagliardi; Pierre Amarenco; Daniel Bereczki; Shinichiro Uchiyama; Arne Lindgren; Matthias Endres; Raf Brouns; Byung-Woo Yoon; George Ntaios; Roland Veltkamp; Keith W Muir; Serefnur Ozturk; Antonio Arauz; Natan Bornstein; Alan Bryer; Martin J O'Donnell; Jeffrey Weitz; Frank Peacock; Ellison Themeles; Stuart J Connolly Journal: Eur Stroke J Date: 2016-08-03