The role of classic risk factors and prothrombotic factor gene mutations in ischemic stroke risk development in young and middle-aged individuals

Supanc, Višnja and Sonicki, Zdenko and Vukasović, Ines and Vargek Solter, Vesna and Zavoreo, Iris and Bašić Kes, Vanja (2014) The role of classic risk factors and prothrombotic factor gene mutations in ischemic stroke risk development in young and middle-aged individuals. Journal of Stroke and Cerebrovascular Diseases, 23 (3). e171-e176. ISSN 1052-3057

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BACKGROUND: In young individuals, a genetically predisposing hypercoagulability and classic modifying risk factors can act synergistically on the ischemic stroke risk development. The aim of the study was to compare the prevalence of classic vascular risk factors and polymorphisms of the G20210A coagulation factor II (prothrombin), Arg506Glu coagulation factor V Leiden, C677T methylenetetrahydrofolate reductase (MTHFR), and 4G/5G plasminogen activator inhibitor-1 (PAI-1) and the impact of these gene mutations and classic vascular risk factors on the overall stroke risk in individuals aged 55 years or younger. ----- METHODS: The study included 155 stroke patients aged 55 years or younger and 150 control subjects. Stroke prevalence and odds ratio (OR) were assessed for the following parameters: G20210A prothrombin, Arg506Glu factor V Leiden, C677T MTHFR, and 4G/5G PAI-1 polymorphisms; total number of study polymorphisms in a particular subject (genetic sum); and classic vascular risk factors of hypertension, obesity, diabetes mellitus, cigarette smoking, hypercholesterolemia, hypertriglyceridemia, and elevated levels of low-density lipoprotein (LDL) cholesterol and very low-density lipoprotein cholesterol. ----- RESULTS: The prevalence of hypertension (P < .001), smoking (P < .001), decreased HDL cholesterol levels (P < .001), obesity (P = .001), elevated LDL cholesterol (P = .036), C677T MTHFR polymorphism (P < .001), and genetic sum was significantly higher in the group of stroke patients. The following parameters were found to act as independent risk factors for ischemic stroke: decreased HDL cholesterol level (P < .001; OR 4.618; 95% confidence interval [CI] 2.381-8.957); hypertension (P = .001; OR 2.839; 95% CI 1.519-5.305); obesity (P = .040; OR 2.148; 95% CI 1.036-4.457); smoking (P = .001; OR 2.502; 95% CI 1.436-4.359); and genetic sum as a continuous variable (P < .01; OR 2.307; 95% CI 1.638-3.250). ----- CONCLUSIONS: Gene mutations of the procoagulable and proatherosclerotic factors investigated exerted a synergistic action in the development of overall risk of ischemic stroke in young and middle-aged individuals.

Item Type: Article
Additional Information: Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.
MeSH: Adult ; Age Factors ; Blood Coagulation/genetics ; Brain Ischemia/blood ; Brain Ischemia/epidemiology ; Brain Ischemia/genetics ; Case-Control Studies ; Chi-Square Distribution ; Croatia/epidemiology ; Factor V/genetics ; Female ; Genetic Predisposition to Disease ; Humans ; Logistic Models ; Male ; Methylenetetrahydrofolate Reductase (NADPH2)/genetics ; Middle Aged ; Multivariate Analysis ; Mutation ; Odds Ratio ; Phenotype ; Plasminogen Activator Inhibitor 1/genetics ; Prevalence ; Prospective Studies ; Prothrombin/genetics ; Risk Factors ; Stroke/blood ; Stroke/epidemiology ; Stroke/genetics ; Thrombophilia/blood ; Thrombophilia/complications ; Thrombophilia/epidemiology ; Thrombophilia/genetics
Departments: Katedra za medicinsku statistiku, epidemiologiju i medicinsku informatiku
Depositing User: Marijan Šember
Status: Published
Sonicki, ZdenkoUNSPECIFIED
Vukasović, InesUNSPECIFIED
Vargek Solter, VesnaUNSPECIFIED
Date: March 2014
Date Deposited: 10 Dec 2015 12:42
Last Modified: 20 Jul 2020 07:51
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