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. 2018 May;45(4):504-511.
doi: 10.1007/s11239-018-1631-4.

Prothrombotic factors do not increase the risk of recurrent ischemic events after cryptogenic stroke at young age: the FUTURE study

Mijntje M I Schellekens  1 , Mayte E van Alebeek  1 , Renate M Arntz  1 , Nathalie E Synhaeve  2 , Noortje A M M Maaijwee  3 , Hennie C Schoonderwaldt  1 , Maureen J van der Vlugt  4 , Ewoud J van Dijk  1 , Loes C A Rutten-Jacobs  5 , Frank-Erik de Leeuw  6
Affiliations

Prothrombotic factors do not increase the risk of recurrent ischemic events after cryptogenic stroke at young age: the FUTURE study

Mijntje M I Schellekens et al. J Thromb Thrombolysis. 2018 May.

Abstract

Background: The role of hypercoagulable states and preceding infections in the etiology of young stroke and their role in developing recurrent ischemic events remains unclear. Our aim is to determine the prevalence of these conditions in patients with cryptogenic stroke at young age and to assess the long-term risk of recurrent ischemic events in patients with and without a hypercoagulable state or a recent pre-stroke infection with Borrelia or Syphilis.

Patients and methods: We prospectively included patients with a first-ever transient ischemic attack or ischemic stroke, aged 18-50, admitted to our hospital between 1995 and 2010. A retrospective analysis was conducted of prothrombotic factors and preceding infections. Outcome was recurrent ischemic events.

Results: Prevalence of prothrombotic factors did not significantly differ between patients with a cryptogenic stroke and with an identified cause (24/120 (20.0%) and 32/174 (18.4%) respectively). In patients with a cryptogenic stroke the long-term risk [mean follow-up of 8.9 years (SD 4.6)] of any recurrent ischemic event or recurrent cerebral ischemia did not significantly differ between patients with and without a hypercoagulable state or a recent infection. In patients with a cryptogenic stroke 15-years cumulative risk of any recurrent ischemic event was 24 and 23% in patients with and without any prothrombotic factor respectively.

Conclusions: The prevalence of prothrombotic factors and preceding infections did not significantly differ between stroke patients with a cryptogenic versus an identified cause of stroke and neither is significantly associated with an increased risk of recurrent ischemic events after cryptogenic stroke.

Keywords: Blood coagulation factors; Infection; Prognosis; Risk factors; Stroke.

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Conflict of interest statement

Conflict of interest

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Figures

Fig. 1
Fig. 1
Cumulative risk of a any recurrent ischemic event and b recurrent cerebral ischemia after cryptogenic stroke in patients with and without any prothrombotic factor
See this image and copyright information in PMC

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