Factor VIII in the Setting of Acute Ischemic Stroke Among Patients With Suspected Hypercoagulable State

Abstract

Background Elevation of factor VIII is associated with higher risk of large vessel arterial occlusions including stroke. Methods Factor VIII levels were examined in consecutive patients with acute ischemic stroke (AIS) presenting to a single center between July 2008 and May 2012. Factor VIII levels exceeding the laboratory reference range were considered elevated (>150%). Results Factor VIII level was elevated in 72.4% (84 of 116) of the patients. Elevated factor VIII level was more frequent in blacks, diabetics, and patients who were anemic. Patients with elevated factor VIII had higher median baseline National Institute of Health Stroke Scale (NIHSS; 5 vs 2, P = .0295) and twice the frequency of neuroworsening (21.4% vs 9.4%), but discharge NIHSS and modified Rankin Scale were similar in the groups. Conclusions High factor VIII level was found in the majority of tested patients with AIS. Several baseline differences were found between patients with normal and high factor VIII levels, but no differences were identified in outcome.

Factoring in Factor VIII With Acute Ischemic Stroke

“…10 However, we found that combined elevations of FVIII and vWF were associated with worse neurologic outcome (defined as discharge modified Rankin Scale score > 2). 28 There also appeared to be a clinically significant association between FVIII and vWF levels and inpatient complications (such as infection), neurologic deterioration (defined as an increase in NIHSS score of 2 or more within a 24-hour period 37 ), and recurrent thrombotic events following acute ischemic stroke.…”

A Model for Predicting Persistent Elevation of Factor VIII among Patients with Acute Ischemic Stroke

“…1,13 This study proposes a novel model by which clinicians can use patients’ baseline characteristics to predict which patients will have persistent elevation of FVIII post-AIS.…”

“…Prior research has illustrated an association between FVIII elevation and increased risk of venous thrombosis and recurrent thromboembolic events. 1–4 Additionally, elevated FVIII is an independent risk factor for acute ischemic stroke (AIS) and coronary artery disease. 1,5,6 …”

“…1 In the context of ischemic stroke, elevation of FVIII is thought to be a result of the local inflammation produced during the acute phase of stroke. 1,7 However, recent studies have demonstrated that elevated levels of FVIII may persist independent of the acute-phase response in the setting of venous thromboembolism. 8 Persistent elevation of FVIII has not been investigated in the context of AIS.…”

The correlation of D-dimer levels with patient outcomes in acute ischemic cerebrovascular disease complicating coronary heart disease

“…4 Patients who have acute ischemic cerebrovascular disease(AICVD) complicating coronary heart disease(CHD) are frequently encountered in clinical practice 5 , and tend to have worse outcomes such as the loss of the independent walking even independent living. 6 Due to the medical technology advancements in the last 10 years, our understanding of the pathophysiology of stroke is expanding, This has led to the development of numerous theories such as intimal injury, 7, 8 activation of coagulation system, 9,10 and inflammatory immune regulation, 11,12 etc. However, all treatments on stroke were aimed to improve neurological deficit and its prevention, systemic observations, and studies of the correlations of neurological deficits, and hematological indices of these patients are of great value for the choice of the therapy and the improvement of the prognosis.…”