Joseph Tarsia1, Tiffany R Chang2, Aimee Aysenne3, Amelia K Boehme4, Alton E Sartor5, Karen C Albright6, Ethan Arda Yalvac, Rebecca Kruse-Jarres, Cindy Leissinger, Sheryl Martin-Schild. 1. Stroke Program, Department of Neurology, Tulane University Medical School, USA. 2. Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, USA. 3. Services and Outcomes Research Center for Outcome and Effectiveness Research and Education (COERE), School of Medicine, University of Alabama at Birmingham, USA. 4. Center of Excellence in Comparative Effectiveness Research for Eliminating Disparities (CERED) Minority Health & Health Disparities Research Center (MHRC), School of Medicine, University of Alabama at Birmingham, 35294. 5. Memorial Herman Hospital, USA. 6. Stroke Program, Department of Neurology, University of Texas in Houston, USA.
Abstract
BACKGROUND: Elevated factor VIII (FVIII) has been linked with higher risk of vascular events. We aimed to determine the relationship between FVIII and hypertension in patients with acute ischemic stroke. METHODS: FVIII levels and transthoracic echocardiogram reports were reviewed in patients with acute ischemic stroke who presented to our stroke center between July 2008 and September 2011. Presenting systolic and diastolic blood pressure, history of hypertention, left ventricular hypertrophy, diastolic dysfunction, and depressed left ventricular function (ejection fraction <50%) were compared in patients with normal and elevated FVIII levels. RESULTS: No differences in presenting blood pressure or frequency of hypertension history were found based on FVIII level. Patients with elevated FVIII had demonstrated a statistically significant higher frequency of diastolic dysfunction (64.8 vs. 43.6%, p=0.042) and a trend towards higher frequency of left ventricular hypertrophy (18.5 vs 5.1%, p=0.073). Median FVIII was significantly higher in patients with left ventricular hypertrophy (194.4 vs 152.9%, p=0.042) and diastolic dysfunction (180.5 vs 149.3%, p=0.031) than patients without these findings. CONCLUSIONS: Among patients with acute ischemic stroke, FVIII levels were higher when there was evidence of hypertensive heart disease. Synthesis of FVIII may be augmented by the ongoing presence of shear stress and could contribute to the higher risk of vaso-occlusive events in patients with elevated FVIII.
BACKGROUND: Elevated factor VIII (FVIII) has been linked with higher risk of vascular events. We aimed to determine the relationship between FVIII and hypertension in patients with acute ischemic stroke. METHODS:FVIII levels and transthoracic echocardiogram reports were reviewed in patients with acute ischemic stroke who presented to our stroke center between July 2008 and September 2011. Presenting systolic and diastolic blood pressure, history of hypertention, left ventricular hypertrophy, diastolic dysfunction, and depressed left ventricular function (ejection fraction <50%) were compared in patients with normal and elevated FVIII levels. RESULTS: No differences in presenting blood pressure or frequency of hypertension history were found based on FVIII level. Patients with elevated FVIII had demonstrated a statistically significant higher frequency of diastolic dysfunction (64.8 vs. 43.6%, p=0.042) and a trend towards higher frequency of left ventricular hypertrophy (18.5 vs 5.1%, p=0.073). Median FVIII was significantly higher in patients with left ventricular hypertrophy (194.4 vs 152.9%, p=0.042) and diastolic dysfunction (180.5 vs 149.3%, p=0.031) than patients without these findings. CONCLUSIONS: Among patients with acute ischemic stroke, FVIII levels were higher when there was evidence of hypertensive heart disease. Synthesis of FVIII may be augmented by the ongoing presence of shear stress and could contribute to the higher risk of vaso-occlusive events in patients with elevated FVIII.
Authors: Eric Y Yang; Lloyd Chambless; A Richey Sharrett; Salim S Virani; Xiaoxi Liu; Zhengzheng Tang; Eric Boerwinkle; Christie M Ballantyne; Vijay Nambi Journal: Stroke Date: 2011-10-27 Impact factor: 7.914
Authors: Larry B Goldstein; Cheryl D Bushnell; Robert J Adams; Lawrence J Appel; Lynne T Braun; Seemant Chaturvedi; Mark A Creager; Antonio Culebras; Robert H Eckel; Robert G Hart; Judith A Hinchey; Virginia J Howard; Edward C Jauch; Steven R Levine; James F Meschia; Wesley S Moore; J V Ian Nixon; Thomas A Pearson Journal: Stroke Date: 2010-12-02 Impact factor: 7.914
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