Elevated factor VIII level and stroke in patients without traditional risk factors associated with cardiovascular diseases

Abstract Background: Retinal vascular occlusion (RVO), both arterial (RAO) and venous (RVO) is an important cause of visual loss. Inherited and acquired thrombophilia are considered important risk factors in the development of RVO. Additionally, cardiovascular risk factors such as hypertension, diabetes, hyperlipidemia, smoking and use of female hormones may play a role. Objective: To determine the prevalence of thrombophilia in patients with RVO. Methods: We reviewed the medical records of all patients with documented RVO who were referred to our hematology clinic at a tertiary care center between January 2001 and June 2008 for thrombophilia evaluation. Thrombophilia evaluation included testing for factor V Leiden, prothrombin gene mutation G20210A, deficiencies in antithrombin, protein C and S, presence of antiphospholipid antibodies (aPLas), hyperhomocysteinemia and increased levels of lipoprotein (a), factor VIII, IX and XI. Serum protein electrophoresis and immunofixation were also performed. Environmental risk factors analyzed included use of female hormones, pregnancy and puerperium, smoking, hypertension, hyperlipidemia and diabetes. Results: A total of 24 patients were identified; 10 were males and 14 females. The mean age was 62 years (range, 31 to 86 years). Seven patients had RAO and 17 RVO. Of the 24 patients, 19 (79%) had thrombophilia. Of these, 10 had only one thrombophilia and 9 had ≥2 thrombophilia. Of the 10 patients with a single thrombophilia, 3 patients had aPLas, 3 had increased lipoprotein (a) 2 had factor V Leiden, 1 hyperhomocysteinemia, and 1 had increased factor VIII level. Of the nine patients with combined thrombophilia: 3 had hyperhomocysteinemia and increase factor VIII level, 2 prothrombin gene mutation and positive lupus anticoagulant, 1 positive aPLas, hyperhomocysteinemia and a monoclonal gammopathy, 1 aPLas and increased factor VIII, 1, hyperhomocysteinemia and protein S deficiency and 1 hyperhomocysteinemia and polycythemia vera. In 5 patients, no thrombophilia was identified. Of the 24 patients, 11 had hypertension, 9 had hyperlipidemia, 3 were smokers, 3 were using female hormones and 1 was pregnant. Treatment included aspirin 81 mg (n= 9), aspirin >81 mg (n= 5), warfarin (n= 3), folic acid (n=2), aspirin and clopidogrel (n=1), clopidogrel (n=1), no treatment (n=4), and unknown (n=1). Conclusions: Over three quarters (79%) of patients with RVO had an underlying thrombophilia with aPLas, hyperhomocysteinemia and increased factor VIII level being the most prevalent. Our findings suggest that testing for thrombophilia particularly for aPLas, homocysteine and factor VIII levels may be useful in patients with RVO

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Elevated factor VIII levels and arterial stroke: a review of literature with a case report

The Egyptian Journal of Neurology Psychiatry and Neurosurgery ◽

10.1186/s41983-021-00275-7 ◽

2021 ◽

Vol 57 (1) ◽

Author(s):

Dinesh Khandelwal ◽

Vaibhav Mathur ◽

Arvind Vyas ◽

Chandani Shah ◽

Chandrajeet Singh Ranawat ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Factor Viii ◽

Young Patients ◽

Treatment Protocol ◽

Factor Viii Level ◽

Identifiable Risk Factor ◽

Viii Level ◽

Independent Effects

Abstract Background Cerebral arterial thromboses or ischemic strokes may be caused by cumulative or independent effects of a variety of risk factors. High factor VIII level is one of those important but less known risk factors for arterial and venous thrombosis. We hereby provide a comprehensive review of the role of high factor VIII levels as a risk factor of arterial thrombosis. Moreover, we present our views on inclusion of factor VIII testing in the etiology workup protocol of young patients with ischemic strokes and their treatment with anticoagulant therapy. Case presentation We illustrate a case of 32-year-old North Indian female patient with Ischemic stroke whose only identifiable risk factor was revealed to be an elevated factor VIII level. She was treated with oral anticoagulant with an uneventful follow-up of 6 months. Conclusions Elevated factor VIII levels have their independent and additive effects in causation and prognosis of arterial strokes. We herein discuss the mechanism of this association, the feasibility and yield of routine testing, appropriate cut-off levels, and further treatment protocol especially in young stroke patients.

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Laboratory Detection of Female Carriers of Canine Hemophilia

Thrombosis and Haemostasis ◽

10.1055/s-0038-1655621 ◽

1964 ◽

Vol 12 (02) ◽

pp. 368-376 ◽

Cited By ~ 3

Author(s):

B. J Parks ◽

K. M Brinkhous ◽

P. F Harris ◽

G. D Penick

Keyword(s):

Factor Viii ◽

Partial Thromboplastin Time ◽

Screening Test ◽

Factor Viii Level ◽

Viii Level ◽

Antihemophilic Factor ◽

Female Carriers

SummaryFemales known to be heterozygous for canine hemophilia had a plasma antihemophilic factor (AHF, factor VIII) level of about 50%, as determined by bioassay and by the effectiveness of their transfused plasma in raising the AHF levels of hemophilic dogs. Determination of the plasma AHF should serve to identify transmitter females prior to appearance of affected progeny in litters. Lyon’s hypothesis appears to apply to our findings.The simple partial thromboplastin time (PTT) test was prolonged in heterozygous females. Modifications of the test, by the addition of thrombin, a serum accelerator preparation, or kaolin, gave consistently longer PTT values for heterozygotes than for normal dogs. The PTT appears useful as a screening test for carriers of canine hemophilia.

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Factor-VIII Inhibitor in Less Severely Affected Haemophilic Patients

10.1055/s-0039-1689668 ◽

1975 ◽

Author(s):

E. G. D. Tuddenham ◽

A. L. Bloom ◽

J. C. Giddings ◽

C. A. Barrett

Keyword(s):

Factor Viii ◽

Factor Viii Inhibitor ◽

Factor Viii Level ◽

Replacement Treatment ◽

Viii Level ◽

Viii Inhibitor ◽

In Vivo Recovery ◽

Better Than

The occurrence of factor VIII inhibitor in five mild or moderately affected liaemophilic patients is described. In four patients the inhibitor inactivated endogenous factor VIII an dtemporarily converted them to severely affected haemophiliacs with factor VIII level of 0%. In the fifth patient, a brother of one of the others, the inhibitor although more potent did not inactivate the patient’s own factor VIII and did not completely inactivate normal factor VIII in vitro. This patient responded to treatment with factor-VIII concentrate but the in-vivo recovery was reduced. The patient’s plasma was tested against a panel of normal donors but it inactivated factor VIII in each to a similar extent and no evidence for normal factor-VIII groups was obtained. In the other patients the response to replacement treatment was also better than that usually seen in severely affected haemophilic patients with inhibitor. In the two related patients the inhibitors have so far persisted but in the unrelated patients the inhibitors eventually disappeared and did not always recur with subsequent therapy. The incidence of factor- VIII inhibitor in less severe haemophiliacs (factor VIII > 3% ) in this centre is 6% suggesting that the complication is more frequent in this type of patient than hitherto recognised.

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ROLE OF VARIOUS RISK FACTORS ASSOCIATED WITH CARDIOVASCULAR DISEASES

International Research Journal of Pharmacy ◽

10.7897/2230-8407.04511 ◽

2013 ◽

Vol 4 (5) ◽

pp. 44-50

Author(s):

Pranay Wal ◽

Ankita Wal ◽

Nikita Saraswat ◽

Shalini Singh ◽

Shikha Bajpai

Keyword(s):

Risk Factors ◽

Cardiovascular Diseases ◽

Factors Associated

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Further Experience on the Effect of High Pre-Donation Factor VIII Levels in Blood Donors on the Factor VIII Content of Small-Pool Fractions

10.1055/s-0039-1682568 ◽

1977 ◽

Author(s):

H. Beeser ◽

H. Eqli

Keyword(s):

Factor Viii ◽

High Plasma ◽

Activity Levels ◽

Factor Viii Activity ◽

Factor Viii Level ◽

Plasma Factor ◽

Viii Level ◽

Factor Viii Concentrates ◽

Small Pool ◽

Concentrate Preparation

Because of the well known wide normal range of the factor VIII activity between 60 to 170% I man, selecting of donors with high activity levels would be of advantaae for the preparation of factor VIII concentrates. This is especially true for preparing small-pool fractions, as for technical reasons the final product cannot be controlled for its factor VIII content. In preliminary investigations, we reported on elsewhere, high factor VIII activity in donors estimated before a donation had been rarely reproducible before a second donation after 8-12 weeks. So as a preliminary result of finding a donor’s factor VIII level varying from donation to donation selecting of plasmas with high factor VIII content for concentrate preparation could only be establishedby re-estimating the activity before each donation. Proceeding in this way would be much too troublesome. To get more reliable information whether a healthy subject’s high factor VIII plasma level is distinctly varying or rather constant we assayed the plasma of 200 donors with factor VIII activity > 120% two times more before donation. The results confirmed our preliminary findings, especially the fact that a high plasma factor VIII activity in experienced donors was rarely reproducible when re-estimated before a second and third donation. As a consequence selecting of donors with high factor VIII procoaqulant activity for preparing small-pool factor VIII concentrates is impracticable.

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PARAMETERS OF ECG DISPERSION MAPPING AMONG STUDENTS OF NORTHERN UNIVERSITY

Bulletin of Nizhnevartovsk State University ◽

10.36906/2311-4444/19-2/12 ◽

2019 ◽

pp. 98-104 ◽

Cited By ~ 1

Author(s):

I. A Pogonysheva ◽

D. A Pogonyshev ◽

I. I Lunyak

Keyword(s):

Risk Factors ◽

Cardiovascular Diseases ◽

High Risk ◽

Questionnaire Survey ◽

Cardiac Activity ◽

State University ◽

Men And Women ◽

Factors Associated ◽

Far North ◽

Pathological Characteristics

The cardiac activity of students who have been born and live in the territory equated to regions of Far North was assessed. In total, 132 students of Nizhnevartovsk State University were examined using the CardioVisor-06c analyser that helps to diagnose dysfunctions of the cardiovascular system at preclinical level. The authors conducted a questionnaire survey to identify risk factors associated with cardiovascular diseases in students and analyzed the results of ECG dispersion mapping. The deterioration of the functional state of the myocardium was more pronounced among students with a high risk of developing cardiovascular diseases. The young men and women with pre-pathological characteristics of electrophysiological indicators were referred for additional examination and cardiology consultation.

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TRADITIONAL RISK FACTORS OF CARDIOVASCULAR DISEASES. (LITERATURE REVIEW)

Theoretical & Applied Science ◽

10.15863/tas.2018.01.57.28 ◽

2018 ◽

Vol 57 (01) ◽

pp. 156-160

Author(s):

Guljan Risbayevna Dyusebayeva ◽

◽

Sarviniso Islamovna Ibragimova ◽

Keyword(s):

Risk Factors ◽

Cardiovascular Diseases ◽

Literature Review ◽

Traditional Risk Factors

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Hematogenous thrombophilia as an additional risk factor for cerebral circulation disorders

Тромбоз, гемостаз и реология ◽

10.25555/thr.2021.4.0996 ◽

2021 ◽

Author(s):

И.В. Куртов ◽

С.П. Кривова ◽

Р.К. Хайретдинов ◽

И.Л. Давыдкин

Keyword(s):

Risk Factor ◽

Factor Viii ◽

Blood Coagulation ◽

Genetic Polymorphisms ◽

Additional Risk Factor ◽

Factor Viii Level ◽

Aged Patients ◽

Additional Risk ◽

Viii Level ◽

The Impact

Введение. Гематогенная тромбофилия служит дополнительным фактором риска нарушений мозгового кровообращения (НМК). Цель исследования: изучить влияние повышенного уровня фактора VIII и нарушений в системе фибринолиза на НМК у пациентов с сочетанной патологией системы свертывания крови. Материалы и методы. Обследовано 20 пациентов с перенесенными ишемическими инсультами в возрасте от 36 до 56 лет. Определяли показатели плазменного, тромбоцитарного звеньев гемостаза, системы фибринолиза, а также генетические полиморфизмы системы гемостаза. Результаты. У всех пациентов выявлены различные сочетания генетических полиморфизмов, связанных с изменениями антикоагулянтного звена гемостаза, а также дефекты системы фибринолиза и коагуляционного звена гемостаза, что является дополнительным фактором риска НМК. Заключение. У пациентов молодого и среднего возраста, перенесших острое НМК по ишемическому типу, необходимо исследование системы свертывания крови, включающее определение содержания фактора VIII в крови, показателей системы фибринолиза и уровня гомоцистеина. Background. Hematogenous thrombophilia is an additional risk factor for cerebral circulatory disorders (ССD). Objectives: to study the impact of increased factor VIII level and disturbances of fibrinolysis system on ССD in patients with combined pathology of blood coagulation. Patients/Methods. We examined 20 patients with ischemic strokes aged from 36 to 56 years. The parameters of plasma hemostasis, platelet function, fibrinolysis system, as well as the genetic polymorphisms of hemostasis system were determined. Results. All patients had different combinations of genetic polymorphisms associated with anticoagulant hemostasis changes, as well as defects in fibrinolysis system and coagulation hemostasis that is an additional risk factor for ischemic stroke. Conclusions. In young and middle-aged patients with history of acute ischemic ССD, it is necessary to study blood coagulation, including the determination of blood factor VIII level, fibrinolysis system parameters and homocysteine content.

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“I feel fine. Do I really need to take a cholesterol pill?”

HIV ◽

10.1093/med/9780190088316.003.0021 ◽

2020 ◽

pp. 189-200

Author(s):

Arvind Nishtala ◽

Matthew J. Feinstein

Keyword(s):

Risk Factors ◽

Antiretroviral Therapy ◽

Cardiovascular Diseases ◽

Chronic Condition ◽

Clinical Manifestations ◽

Epidemiological Studies ◽

Communicable Diseases ◽

Non Communicable Diseases ◽

The Past ◽

Traditional Risk Factors

With widespread antiretroviral therapy (ART) accessibility and uptake, HIV has transitioned in many ways to a chronic condition marked by heightened risks of non-communicable diseases. Several clinical and epidemiological studies over the past two decades have demonstrated elevated risks for cardiovascular diseases (CVDs) among people with HIV. These risks appear to be particularly elevated among people with histories of long periods of uncontrolled viremia and CD4 lymphopenia, and dovetail with traditional risk factors (such as smoking) that are common among people with HIV. This chapter presents a discussion of the evolving epidemiology, clinical manifestations, and putative mechanisms of CVDs among people with HIV.

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