Abstract
Background: It has been proposed that activated protein C resistance (APCR) due to the factor
V Leiden (FVL) mutation may be a risk factor for stroke in young adults. However,
this may not be the case for all ethnic groups due to variability in the prevalence
of the FVL mutation. Methods: Case series from a university neurology clinic. Patients with an APCR ratio of 2.2
or below were tested for the FVL mutation (nine patients). Patients on warfarin were
also tested for the FVL mutation (14 patients). Results: 38 African American patients under age 55 with an arterial stroke were identified.
The mean age of the patients is 43.1 years. Five percent had an APCR ratio of 2.0
or below. None of the patients with an APCR ratio of 2.2 or below or the patients
directly tested for the FVL mutation had the mutant allele. Conclusions: Activated protein C resistance due to the FVL mutation does not appear to be a major
risk factor for stroke in young African Americans. Other, as yet unidentified, mechanisms
leading to activated protein C resistance may be important in a small subset of young
African American stroke patients.
Keywords
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References
- Geographic variation in stroke mortality in blacks and whites in the United States.Stroke. 1997; 28: 1639-1647
- Traditional risk factors and ischemic stroke in young adults: the Baltimore–Washington cooperative young stroke study.Arch Neurol. 1996; 53: 603-607
- Resistance to activated protein C, the Arg506 to Gln mutation in the factor V gene, and venous thrombosis.Thromb Haemost. 1995; 73: 739-742
- Ethnic distribution of factor V Leiden in 4047 men and women. Implications for venous thromboembolism screening.JAMA. 1997; 277: 1305-1307
- World distribution of factor V Leiden.Lancet. 1995; 346: 1133-1134
- Classification of subtype of acute ischemic stroke: definitions for use in a multicenter clinical trial.Stroke. 1993; 24: 35-41
- Modified test for activated protein C resistance.Lancet. 1994; 344: 1162-1163
- Sensitivity and specificity of the APC resistance assay in detection of individuals with factor V Leiden.Am J Clin Pathol. 1996; 106: 107-111
- Increased levels of activated factor VII and decreased plasma protein S activity and circulating thrombomodulin during use of oral contraceptives.Thromb Haemost. 1996; 76: 729-734
- Third-generation oral contraceptives and low free protein S as a risk factor for venous thrombosis.Lancet. 1996; 347: 397
- Increased rate of factor V Leiden mutation in patients with cerebral venous thrombosis.J Neurol. 1998; 245: 149-152
- Mutation in the gene coding for coagulation factor V and the risk of myocardial infarction, stroke, and venous thrombosis in apparently healthy men.N Engl J Med. 1995; 332: 912-917
- Reduced response to activated protein C is associated with increased risk for cerebrovascular disease.Ann Intern Med. 1996; 125: 265-269
Nabavi DG et al. Factor V gene mutation is a risk factor for cryptogenic stroke of the young. Cerebrovasc Dis 1997;7(Suppl 4):16 (abstract).
- Ischemic stroke in the elderly: role of the common factor V mutation causing resistance to activated protein C.Stroke. 1996; 27: 44-48
- Prevalence of the factor V-Leiden mutation in four distinct American ethnic populations.Am J Med Genet. 1997; 73: 334-336
- Prevalence of factor V Leiden in African Americans.Res Commun Molec Pathol Pharmacol. 1998; 99: 339-343
- A racial difference in the prevalence of the Arg506–Gln mutation.Thromb Res. 1996; 81: 577-581
- Factor V Leiden is not responsible for stroke in patients with sickling disorders and is uncommon in African Americans with sickle cell disease.Am J Hematol. 1997; 54: 12-15
- Multiple hemostatic abnormalities in young adults with activated protein C resistance and cerebral ischemia.J Neurol Sci. 1998; 159: 209-212
- Activated protein C resistance in ischemic stroke not due to factor V Arg 506 Glutamine mutation.Stroke. 1996; 27: 1163-1166
Article info
Publication history
Accepted:
December 24,
1998
Received in revised form:
November 20,
1998
Received:
October 14,
1998
Identification
Copyright
© 1999 Elsevier Science B.V. Published by Elsevier Inc. All rights reserved.
