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A DECREASED INCIDENCE RATE OF ISCHEMIC STROKE IN PATIENTS WITH SEVERE FACTOR XI DEFICIENCY SUGGESTS THAT THE DEFICIENCY CONFERS PROTECTION

Abstract number: P-M-203

Salomon¹ O., Steinberg² D.M., Koren-Morag³ N., Seligsohn¹ U.

¹¹Amalia Biron Research Institute of Thrombosis and Hemostasis, Sheba Medical Center, Tel Hashomer ²²Department of Statistics ³³Department of Epidemiology and Preventive Medicine, Tel Aviv University, Tel Aviv, Israel

How-to-cite Salomon O, Steinberg DM, Koren-Morag N, Seligsohn U. A DECREASED INCIDENCE RATE OF ISCHEMIC STROKE IN PATIENTS WITH SEVERE FACTOR XI DEFICIENCY SUGGESTS THAT THE DEFICIENCY CONFERS PROTECTION. J Thromb Haemost 2007; 5 Supplement 2: P-M-203

Abstract

Introduction: Severe factor XI (FXI) deficiency, an injury-related bleeding disorder, does not protect patients against myocardial infarction (J Thromb Haemost 1:658, 2003). However, in mice, FXI deficiency is protective against FeCl3 – induced carotid artery thrombosis and middle cerebral transient ischemic reperfusion injury. In this study, possible protection against ischemic stroke was examined in patients with severe FXI deficiency.

Methods: Age and gender – specific annual incidence rates for first ischemic stroke were derived from a 2004 National Acute Stroke Israeli Survey and used to compute the expected number of stroke cases in a cohort of patients with severe FXI deficiency. Three major stroke risk factors in the FXI deficient patients were compared to those in the general population.

Results: For a cohort of 125 patients (57 males and 68 females aged 40 years or more) with severe FXI deficiency (activity less than 15 U/dL), the expected number of strokes was 8.15 (5.46 in males and 2.69 in females). Only one woman among FXI deficient patients had a stroke, yielding a significantly different incidence (p=0.0053 by Poisson distribution). FXI deficient males had an increased frequency of hypertension compared to the general population and slightly lower rates of dyslipidemia and diabetes, and FXI deficient females had slightly lower rates of dyslipidemia and diabetes.

Conclusions: A remarkably low incidence of ischemic stroke was observed in a cohort of 125 patients with severe FXI deficiency aged 40 years or more, which contrasts with the expected incidence of myocardial infarction previously reported by us. Conceivably, severe FXI deficiency confers protection against thrombosis in cerebral but not in coronary arteries.

To cite this abstract use the following format:

Journal of Thrombosis and Haemostasis 2007; Volume 5, Supplement 2: abstract number

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