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Role of the Interaction between Thrombophilia and Other Risk Factors in the Occurring of Ischemic Stroke in Young Patients: Algerian Restrospective Study about 75 Cases

M. El Horri1, I. Khachaa1, A. Chikh Khelifa1, A. Berrah1, M. Chekkal2, F. Bemmoussat1, L. Benmahdi1, S.E. Belakehal1

1Hospital University Center of Oran, Oran, Algeria, 2University Hospital Establissement of Oran, Oran, Algeria

Abstract Number: PB0022

Meeting: ISTH 2021 Congress

Theme: Arterial Thromboembolism » Cerebrovascular Disorders

Background: Thrombophilia is a multifactorial disease which is mono- or plurigenic and its clinical expression is associated with a heterogeneous expression. The possible association between thrombophilia and ischemic stroke remains controversial. but it is true that its prevalence increases in young patients compared to the oldest.

Aims: We aimed to study inherited and acquired thrombophilias as risk factors for ischemic stroke in young patients, and the interaction with the other thromboembolic risk factors.

Methods: A total of 75 patients aged 18 to 50 years with a confirmed ischemic stroke were included in the study. Investigation for acquired and inherited thrombophilia was done in laboratory hematology unit at the Military University Hospital of Oran, Algeria from 1 January 2017 to 31 December 2019. The same assessment was carried out in 80 healthy subjects considered as controls. Clinical informations were recolted from medical records of neurology unit.

Results: A positive thrombophilia test was identified in 15 (20%) patients. One patient presented with protein C deficiency, 5 patients with protein S deficiency. Activated protein C resistance in two patients. Hyperhomocysteinemia was observed in one patient. Antiphospholipid antibodies were found in 6 patients. The thrombophilia results came back negative in all subjects of the control population. In the presence of thrombophilia the patients had an OR of 1.25 [CI: 1.12 – 1.40] of having an ischemic stroke compared to uninjured subjects.
In 03 patients Thrombophilia has been identified as the only risk factor (02 protein S deficiencies and 01 case of activated protein C resistance), while for the rest of patients (12) , it was associated with other risk factors , like high blood pressure , diabetes , smoking , contraception and dyslipidemia .

Epidemiological and clinical characteristics Risk factors Prevalence of thrombophilia in the study population
Age: 37 years [IQR : 31 – 45]
Sexe: Male: 32(42.7%); Female: 43(57.3%)
Number of episodes: 01 episode: 65(86.7%)
More than 02 episodes: 10(13.3%)
Cryptogenic: 60(80%)
History of DVT or ischemic stroke: 09(12%)
History of foetal loss: 05(6.7%)
Contraception 20(26.7%)
Smoking 19(25.3%)
High blood pressure 17(22.7%)
Dyslipidemia 10(13.3%)
Diabetes 10(13.3%)
Obesity 09(12%)
Inherited thrombophilia: 08(12%)
Protein C deficiency: 01(1.30%)
Protein S deficiency: 05(6.80%)
Activated protein C resistance: 02(2.70%)
Antiphospholipid syndrome: 06(08%)
Lupus anticoagulant: 04(05.30%)
Anti-β2GPI: 02(2.70%)
Anticardiolipin: 03(04%)

Baseline Characteristics and prevalence of thrombophilia in the study patients

Conclusions: Thrombophilia is associated with ishemic stroke in young patients. This association may be stronger in the presence of traditional risk factors.

To cite this abstract in AMA style:

El Horri M, Khachaa I, Chikh Khelifa A, Berrah A, Chekkal M, Bemmoussat F, Benmahdi L, Belakehal SE. Role of the Interaction between Thrombophilia and Other Risk Factors in the Occurring of Ischemic Stroke in Young Patients: Algerian Restrospective Study about 75 Cases [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/role-of-the-interaction-between-thrombophilia-and-other-risk-factors-in-the-occurring-of-ischemic-stroke-in-young-patients-algerian-restrospective-study-about-75-cases/. Accessed May 19, 2022.

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