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Factor V Leiden Is Associated with Atrial Fibrillation, but Not Ischemic Stroke in Atrial Fibrillation. The Tromsø Study

E.M. Hald1, M.-L. Løchen2, E.B. Mathiesen3, I. Njølstad2, S.K. Brækkan1, J.-B. Hansen1

1K. G. Jebsen Thrombosis Research and Expertise Center, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway, 2Epidemiology of Chronic Diseases Research Group, Department of Community Medicine, UiT, Tromsø, Norway, 3Brain and Circulation Research Group, Department of Clinical Medicine, UiT, Tromsø, Norway

Abstract Number: PB2052

Meeting: ISTH 2020 Congress

Theme: Venous Thromboembolism and Cardioembolism » Atrial Fibrillation

Background: Factor V Leiden (FVL) is a prevalent genetic mutation associated with venous thromboembolism, but also with arterial disease and adverse pregnancy outcomes. While atrial fibrillation (AF) is a prothrombotic condition, it is scarcely known to what extent FVL is associated with AF development and subsequent ischemic stroke.

Aims: To investigate whether the presence of FVL was associated with incident AF and ischemic stroke in a cohort recruited from a general population.

Methods: A randomly selected sub-cohort (n=3663) was sampled from the fourth survey of the Tromsø study (1994/1995) and incident cases of AF and ischemic stroke were identified through December 31, 2012. DNA isolated from blood of all participants was genotyped for FVL, and Cox proportional hazards regression models were used to calculate hazard ratios (HR) with 95% confidence intervals (CI) for AF and ischemic stroke by FVL. The regional committee for research ethics approved the study and all study participants provided informed written consent.

Results: 235 participants (6.4%) were carriers of ≥ 1 risk allele in FVL. During follow-up, 545 participants were diagnosed with AF, and 314 participants experienced ischemic stroke. Carriers of FVL had 1.4-fold increased risk of AF (HR 1.37, 95% CI 1.00 – 1.85), and the risk was more pronounced in men (HR 1.52, 95% CI 1.04-2.24) than in women (HR 1.09, 95% CI 0.66 – 1.81). Carriers of ≥ 1 risk allele in FVL did not have significantly increased risk of ischemic stroke (HR 1.22, 95% CI 0.80-1.87). Moreover, while subjects who developed AF had higher risk of subsequent stroke (HR 3.22, 95% CI 2.44-4.25), the presence of FVL did not add to these risk estimates.

Conclusions: FVL was associated with increased risk of incident AF, especially in men. FVL was nevertheless not an important risk factor for ischemic stroke in general, nor in AF patients in particular.

To cite this abstract in AMA style:

Hald EM, Løchen M-, Mathiesen EB, Njølstad I, Brækkan SK, Hansen J-. Factor V Leiden Is Associated with Atrial Fibrillation, but Not Ischemic Stroke in Atrial Fibrillation. The Tromsø Study [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/factor-v-leiden-is-associated-with-atrial-fibrillation-but-not-ischemic-stroke-in-atrial-fibrillation-the-tromso-study/. Accessed November 29, 2023.

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