Von Willebrand factor drives the association between elevated factor VIII and poor outcomes in patients with ischemic stroke

Alyana Samai; Dominique Monlezun; Amir Shaban; Alexander George; Lauren Dowell; Rebecca Kruse-Jarres; Laurie Schluter; Ramy El Khoury; Sheryl Martin-Schild

doi:10.1161/STROKEAHA.114.006394

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Von Willebrand factor drives the association between elevated factor VIII and poor outcomes in patients with ischemic stroke

Journal article

Open access

Peer reviewed

Von Willebrand factor drives the association between elevated factor VIII and poor outcomes in patients with ischemic stroke

Alyana Samai, Dominique Monlezun, Amir Shaban, Alexander George, Lauren Dowell, Rebecca Kruse-Jarres, Laurie Schluter, Ramy El Khoury and Sheryl Martin-Schild

Stroke (1970), Vol.45(9), pp.2789-2791

09/2014

DOI: 10.1161/STROKEAHA.114.006394

PMID: 25028444

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Abstract

Despite clear roles of factor VIII (FVIII) and von Willebrand factor (vWF) in thrombosis, few studies have examined the relationship of these factors with acute ischemic stroke (AIS). We sought to determine whether concurrent elevation in FVIII and vWF was associated with adverse events and outcomes. From our prospective stroke registry, patients consecutively admitted with AIS between July 2008 and October 2013 were included if both FVIII and vWF were measured during admission. The primary outcome was the modified Rankin Scale score on discharge. Among 1453 cases in our stroke registry, 148 patients with AIS met inclusion criteria; 62 patients (41.9%) had FVIII-/vWF-, 16 patients (10.8%) had FVIII+/vWF-, and 51 patients (34.5%) had FVIII+/vWF+. In the fully adjusted model, patients with FVIII+/vWF+ had increased odds of inpatient complications (odds ratio, 8.6; 95% confidence interval, 1.58-46.85; P=0.013) and neuroworsening (odds ratio, 3.2; 95% confidence interval, 1.18-8.73; P=0.022) than patients with FVIII-/vWF-. Adjusted for age, baseline stroke severity, and glucose, patients with FVIII+/vWF+ had increased odds of poor functional outcome (modified Rankin Scale>2; odds ratio, 2.87; 95% confidence interval, 1.16-7.06; P=0.021) than patients with FVIII-/vWF-. Concurrent FVIII/vWF elevation predicts higher odds of inpatient complications, neuroworsening, and worse functional outcomes for patients with AIS compared with patients with normal levels. Our findings suggest that FVIII and vWF levels may serve as clinically useful stroke biomarkers by providing risk profiles for patients with AIS.

Adult

Aged

Aged, 80 and over

Cross-Sectional Studies

Factor VIII - metabolism

Female

Humans

Ischemia - pathology

Male

Middle Aged

Prospective Studies

Registries

Risk Factors

Stroke - blood

Thrombosis - blood

Treatment Outcome

von Willebrand Factor - metabolism

Details

Title: Subtitle: Von Willebrand factor drives the association between elevated factor VIII and poor outcomes in patients with ischemic stroke
Creators: Alyana Samai - Tulane University
Dominique Monlezun - Tulane University
Amir Shaban - Tulane University
Alexander George - Tulane University
Lauren Dowell - Tulane University
Rebecca Kruse-Jarres - Tulane University
Laurie Schluter - Tulane University
Ramy El Khoury - Tulane University
Sheryl Martin-Schild - Tulane University
Resource Type: Journal article
Publication Details: Stroke (1970), Vol.45(9), pp.2789-2791
DOI: 10.1161/STROKEAHA.114.006394
PMID: 25028444
NLM abbreviation: Stroke
ISSN: 0039-2499
eISSN: 1524-4628
Language: English
Date published: 09/2014
Academic Unit: Neurology
Record Identifier: 9984303025602771

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22 Times Cited - Web of Science