Increased Thrombin Generation Is Associated With Acute Ischemic Stroke but Not With Coronary Heart Disease in the Elderly
- 1 June 2011
- journal article
- research article
- Published by Wolters Kluwer Health in Arteriosclerosis, Thrombosis, and Vascular Biology
- Vol. 31 (6), 1445-1451
- https://doi.org/10.1161/atvbaha.111.223453
Abstract
Objective— A high thrombin generation level has been associated with the risk of venous thrombosis. Whether changes in this biomarker are relevant to arterial disease remains unknown. We investigated the association of thrombin generation with coronary heart disease (CHD) and acute ischemic stroke (AIS) in the elderly. Methods and Results— We used data from the Three-City study, a prospective cohort including 9294 subjects aged >65 years. After 4 years of follow-up, a case-cohort study was established. Using the calibrated automated thrombography method, endogenous thrombin potential and peak height were measured in plasma samples of all CHD and AIS cases and a random sample of 1177 controls. We did not find any significant association between thrombin generation and CHD. In multivariate analyses, high levels of endogenous thrombin potential and peak height were associated with an increased risk of AIS (hazard ratio=1.16 [95% CI, 0.90 to 1.50] and 1.31 [95% CI, 1.01 to 1.69] for a 1 SD increase, respectively). Data also suggested that these associations might be more important in women (hazard ratio=1.55 [95% CI, 1.05 to 2.33] and 1.71 [95% CI, 1.11 to 2.63], respectively) than in men (P for interaction=0.04 and 0.08, respectively). Conclusion— Thrombin generation emerges as an independent predictor of AIS, particularly in women. Hypercoagulability may have an important role in the pathogenesis of AIS.Keywords
This publication has 38 references indexed in Scilit:
- Increasing Prevalence of Atrial Fibrillation and Flutter in the United StatesThe American Journal of Cardiology, 2009
- Peak thrombin generation and subsequent venous thromboembolism: the Longitudinal Investigation of Thromboembolism Etiology (LITE) studyJournal of Thrombosis and Haemostasis, 2009
- Gender Differences in Acute Ischemic StrokeStroke, 2009
- Prediction of Recurrent Venous Thromboembolism by Endogenous Thrombin Potential and D-DimerClinical Chemistry, 2008
- High rate of unprovoked recurrent venous thrombosis is associated with high thrombin‐generating potential in a prospective cohort studyJournal of Thrombosis and Haemostasis, 2008
- Sex differences in stroke: epidemiology, clinical presentation, medical care, and outcomesPublished by Elsevier ,2008
- Effects of Conjugated Equine Estrogen on Stroke in the Women’s Health InitiativeCirculation, 2006
- Comparison of the impact of atrial fibrillation on the risk of stroke and cardiovascular death in women versus men (The Copenhagen City Heart Study)The American Journal of Cardiology, 2004
- Sex Differences in First-Ever Acute StrokeStroke, 2003
- Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment.Stroke, 1993