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PLoS One. 2015 Aug 7;10(8):e0133523. doi: 10.1371/journal.pone.0133523. eCollection 2015.

Hypercoagulability Is a Stronger Risk Factor for Ischaemic Stroke than for Myocardial Infarction: A Systematic Review.

Author information

1
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands; Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
2
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands; Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands.
3
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands; Brain Center Rudolph Magnus, Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
4
Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
5
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands; Center for Stroke Research Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany.

Abstract

BACKGROUND AND PURPOSE:

Hypercoagulability increases the risk of arterial thrombosis; however, this effect may differ between various manifestations of arterial disease.

METHODS:

In this study, we compared the effect of coagulation factors as measures of hypercoagulability on the risk of ischaemic stroke (IS) and myocardial infarction (MI) by performing a systematic review of the literature. The effect of a risk factor on IS (relative risk for IS, RRIS) was compared with the effect on MI (RRMI) by calculating their ratio (RRR = RRIS/RRMI). A relevant differential effect was considered when RRR was >1+ its own standard error (SE) or <1-SE.

RESULTS:

We identified 70 publications, describing results from 31 study populations, accounting for 351 markers of hypercoagulability. The majority (203/351, 58%) had an RRR greater than 1. A larger effect on IS risk than MI risk (RRE>1+1SE) was found in 49/343 (14%) markers. Of these, 18/49 (37%) had an RRR greater than 1+2SE. On the opposite side, a larger effect on MI risk (RRR<1-1SE) was found in only 17/343 (5%) markers.

CONCLUSIONS:

These results suggest that hypercoagulability has a more pronounced effect on the risk of IS than that of MI.

PMID:
26252207
PMCID:
PMC4529149
DOI:
10.1371/journal.pone.0133523
[Indexed for MEDLINE]
Free PMC Article

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