Haemostasis in ischaemic stroke and vascular dementia

Stott, David J.; Spilg, Edward G; Campbell, Ailsa M.; Rumley, Ann; Mansoor, M. A.; Lowe, G. D. O.

doi:10.1097/00001721-200112000-00006

Cited by 38 publications

(38 citation statements)

References 28 publications

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“…There are fewer studies on VWF in IS, although increased levels of VWF have been reported in some case-control studies [5][6][7][8][9][10][11]. Furthermore, high plasma levels of VWF have been identified as a predictor of stroke in three prospective studies of subjects with and without atrial fibrillation [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Plasma levels of von Willebrand factor in the etiologic subtypes of ischemic stroke

Hanson

Jood

Karlsson

et al. 2011

Journal of Thrombosis and Haemostasis

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Summary. Background: Compared with coronary artery disease, there are few studies on von Willebrand factor (VWF) in ischemic stroke (IS). Moreover, there is little information on VWF in the etiologic subtypes of IS. Objectives: The aim of the present study was to investigate VWF in IS and in the etiologic subtypes of IS. Patients/methods: The Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS) is a case-control study comprising 600 patients and 600 matched controls. Etiologic IS subtype was defined according to the TOAST criteria. Blood sampling was performed in the acute phase and after 3 months. Results: The levels of VWF were increased in overall IS, at both time-points. The 3-month VWF levels were increased in the subtypes of large-vessel disease (LVD), cardioembolic (CE) stroke and cryptogenic stroke, but not in the subtype of smallvessel disease (SVD), as compared with the controls. The acute phase VWF levels were significantly increased in all four subtypes. In the multivariate regression analysis, with vascular risk factors as covariates, the 3-month VWF levels were associated with CE stroke and cryptogenic stroke, and the acute phase VWF levels with all subtypes. There were significant subtype-specific differences in VWF, with the highest levels in LVD and CE stroke. Conclusions: The present results show that VWF levels are increased in patients with IS. Furthermore, the VWF levels differ between etiologic IS subtypes and thus, it is important to consider etiologic subtypes in future studies of VWF in patients with IS.

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Section: Introductionmentioning

confidence: 99%

Plasma levels of von Willebrand factor in the etiologic subtypes of ischemic stroke

Hanson

Jood

Karlsson

et al. 2011

Journal of Thrombosis and Haemostasis

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“…Higher levels of the hemostatic markers von Willebrand factor (vWF), coagulation factor VIII (FVIII), and D-dimer have also been related to risk of cognitive impairment and dementia. [6][7][8][9] ABO blood group is associated with many forms of CVD, including coronary heart disease (CHD), stroke, and venous thromboembolism. [10][11][12] In general, individuals with blood group O have a reduced risk of CVD.…”

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confidence: 99%

ABO blood type, factor VIII, and incident cognitive impairment in the REGARDS cohort

et al. 2014

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Objective: To assess the relationships among ABO group, factor VIII (FVIII), and incident cognitive impairment in a large, prospective cohort study of black and white adults in the United States using a nested case-control design.Methods: Incident cognitive impairment was defined using cognitive domain tests over a mean follow-up of 3.4 years. ABO blood group was measured by genotyping in a nested case-control sample of 495 cases with cognitive impairment and 587 controls.Results: Those with blood group AB and those with higher FVIII had an increased risk of cognitive impairment, adjusting for age, race, region, and sex (respective odds ratios 1.82, 95% confidence interval [CI] 1.15-2.90; and 1.24, 95% CI 1.10-1.38 for 40 IU/dL higher FVIII). Mean FVIII was higher in those with blood type AB (142 IU/dL; 95% CI 119-165) compared with O (104 IU/dL; 95% CI 101-107), and FVIII mediated 18% of the association between AB group and incident cognitive impairment (95% CI for mediation 230% to 68%).Conclusions: Blood group AB and higher FVIII were associated with increased incidence of cognitive impairment in this prospective study. The association of blood group AB with incident cognitive impairment was not significantly mediated by FVIII levels. There is a growing understanding that cardiovascular disease (CVD) and cognitive impairment share many common risk factors. Hypertension, 1,2 elevated cholesterol, 3 hyperglycemia, 2,4 and obesity 4,5 are all associated with longitudinal declines in cognitive function and dementia. Higher levels of the hemostatic markers von Willebrand factor (vWF), coagulation factor VIII (FVIII), and D-dimer have also been related to risk of cognitive impairment and dementia. [6][7][8][9] ABO blood group is associated with many forms of CVD, including coronary heart disease (CHD), stroke, and venous thromboembolism. [10][11][12] In general, individuals with blood group O have a reduced risk of CVD.13,14 Non-O blood types are associated with higher levels of vWF and FVIII, procoagulant proteins that circulate as a complex in blood, 11,12 because the ABO antigen affects clearance of vWF.15 Levels of both vWF and FVIII are associated with thrombosis, 16 and were recently linked to dementia risk. 17 A recent report demonstrating an association between blood type AB and stroke risk found that 60% of that association was mediated by differences in FVIII level. 18Although ABO blood group is a CVD risk factor, we are not aware of studies on its relationship with cognitive impairment. In this study, we examined the relationships among ABO group, FVIII, and incident cognitive impairment in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. We hypothesized that blood group A, B, or AB would be associated with an increased risk of cognitive impairment relative to group O.

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“…4 The von Willebrand factor (vWF) is synthesized primarily by vascular endothelial cells and promotes platelet adhesion and aggregation, leading to thrombus formation. 1 Increased levels of vWF in stroke patients have been reported in several case-control studies, [5][6][7][8] but prospective studies have been inconsistent, with some showing a positive relationship 9,10 and others showing no relationship [11][12][13][14] between vWF and stroke risk. Fibrin D-dimer is the primary degradation product of cross-linked fibrin and is a marker of activated coagulation and fibrinolysis.…”

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confidence: 99%

“…2 Tissue-type plasminogen activator (tPA), produced and released mainly by endothelial cells, acts on plasminogen to form plasmin, and tPA antigen may be indicative of impaired fibrinolytic function. 3 Circulating levels of D-dimer and tPA are increased in acute stroke 4,6,15,16 and have been shown to be positively associated with incident stroke. 13,14,17,18 The vWF, D-dimer, and tPA levels increase markedly with age, 19 but few studies have examined the associations between coagulation markers, fibrinolytic function, and incident stroke in the elderly population, in whom incident stroke rates are particularly high.…”

mentioning

confidence: 99%

Fibrin D-Dimer, Tissue-Type Plasminogen Activator, von Willebrand Factor, and Risk of Incident Stroke in Older Men

Wannamethee¹,

Whincup²,

Lennon³

et al. 2012

Stroke

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Background and Purposes-Abnormalities in blood coagulation and the fibrinolytic system have been associated with increased risk of stroke, but few prospective studies have studied the associations in older adults. We have examined the associations between fibrin D-dimer, tissue-type plasminogen activator, and von Willebrand factor (vWF) and risk of stroke in older men and examined their predictive roles separately in normotensive and hypertensive men. Methods-Prospective study of 3358 men aged 60 to 79 years with no previous diagnosis of myocardial infarction or stroke and without atrial fibrillation followed-up for an average of 9 years, during which there were 187 incident stroke events. Results-Increased levels of D-dimer and vWF were associated with significantly increased risk of major stroke events after adjustment for potential confounders, including systolic blood pressure (adjusted hazard ratios and 95% confidence interval per standard deviation increase in D-dimer and vWF were 1.

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Haemostasis in ischaemic stroke and vascular dementia

Cited by 38 publications

References 28 publications

Plasma levels of von Willebrand factor in the etiologic subtypes of ischemic stroke

Plasma levels of von Willebrand factor in the etiologic subtypes of ischemic stroke

ABO blood type, factor VIII, and incident cognitive impairment in the REGARDS cohort

Fibrin D-Dimer, Tissue-Type Plasminogen Activator, von Willebrand Factor, and Risk of Incident Stroke in Older Men

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