Elevated Factor VIII: C Level Is a Risk Factor for Cerebral Infarction.

Abstract To explore the association between the risk of cerebral infarction (CI) and markers of coagulation and fibrinolytic systems. A prospective case-control study was carried out in PUMCH, in which 124 unselected patients with CI as well as 91 control patients were studied. Blood samples in acute phase of CI were obtained within 10 days from onset, and the convalescent smples were obtained at least 6 months after onset. Factor VII, FVIII:C, FX, vWF, AT-III, PC, PS, FPS,protein Z( PZ), D-dimer and TAT levels were measured. Associtions were assessed by multiple logistic regression analyses. Compared with control group, levels of FVIII:C, vWF, FVII, DD, TAT in patients with acute CI were marked elevated (FVIII:C194.6±48.6% vs 91.1±26.9%, p=0.000; vWF 123.2±28.8% vs 90.0±20.5%, p=0.003; FVII 98.7±25.2% vs 82.3±25.3%, p=0.002; DD 0.41±0.61 mg/l vs 0.12±0.10 mg/l, p=0.008; TAT 40.9±73.3 ng/ml vs 12.3±11.5 ng/ml, p=0.028, whereas level of FX was not changed significantly. Levels of anticoagulation proteins were decreased. Levels of PZ was 0.41μg/ml lower than cortrol (1.32±0.83μg/ml vs 1.73 ±0.55μg/ml, p=0.004) The result of logistic regression analysis showed levels of FVIII:C and vWF in acute phase were related with CI, with OR 1.143, 95%CI 1.099~1.189, P<0.01 and OR 1.040, 95%CI 1.003~1.082, P<0.05 for FVIII:C and vWF respectively. Compared with acute phase, levels of FVIII:C, DD and TAT in convalescent phase were reduced (FVIII:C 144.3±37.2% vs 193.5±46.2%, P=0.000; DD 0.21±0.20 mg/l vs 0.41±0.78 mg/l,p=0.025; TAT 15.2±10.3 ng/ml vs 42.9±72.6 ng/ml, p=0.030). However, the levels of FVIII:C, vWF and FVII were still higer than that of control(FVIII: C 144.3±47.2%, vs 91.1±26.9%, vWF 110.7±23.2% vs 90.0±20.5%, FVII 93.6±25.5% vs 82.3±25.3%, P<0.05). Level of PZ was elevated by 0.33μg/ml. The result of multiple logistic regression analyses indicated FVIII:C, vWF were the independent risk factors for CI