Affiliations: Department of Neurology-Stroke, State Health Centre, Budapest, Hungary | Laboratory of Molecular Genetics, National Institute of Hemathology, Budapest, Hungary | State Health Centre, Department Internal Medizine, Budapest, Hungary | Semmelweis University, Department of Vascular Neurology, Budapest, Hungary
Note: [] Corresponding author: Endre Pongrácz, MD, State Health Centre, Department of Neurology-Stroke, Róbert Károly krt. 44, 1134 Budapest, Hungary. Tel.: + 36 309 544 704; Fax: + 36 1; E-mail: [email protected].
Abstract: Background: The phenotype caracteristic of blood clotting factors are well known, however few data has been documented about effects on haemorheology. The connection among genetic polymorphisms, haemorheological factors and vascular mortality is also studied poorly. Purpose: Our aim was: to study six genetic polymorphisms of blood clotting factors, which presents the role of platelet–plasmaprotein–endothel system in thrombotic course in controls and ischaemic stroke cohort. Second, to study the connection of genotypes and haemorheologic factors and both with five years vascular mortality in patients. Patients and methods: It was studied the genetic polymorhisms of GP IIb/IIIa Leu33Pro, prothrombin gene G20210A, ACE I/D, fibrinogen gene-455 G/A, Leiden mutation and MTHFR C677T alleles or genotypes in blood samples of 433 ischaemic stroke patients and 173 controls by PCR. Haematocrit values, plasma fibrinogen (FIB) concentration, whole blood viscosity (WBV) at 90 s−1 and also the plasma viscosity (PV) were measured. Vascular mortality of patients were followed during five years and studied by curves Kaplan–Meier. Results: A higher plasma FIB concentration in non smoker patients, carrying A alleles of FIB gene could be observed as compared to wild types (p<0.05). Also a moderate WBV increasing in smoker patients with A alleles was found against wild types (p=0.11), at the same time we observed a significant WBV increasing in non smoker patients (p<0.05). The highest quartile of PV showed a connection with Leiden mutation in whole group of patients (p=0.01), in subgroup of young patients (<50 years) (p=0.03) and also in non smoker groups (p<0.05) as compared to patients having wild types. No association could be detected between different genetic polymorphisms and vascular mortality, however it was observed significant mortality increasing in patients having PV above 1.51 mPa s (p=0.03). Conclusion: Certain genetic polymorphisms of coagulation system could result unfavorable haemorheological changes, however non of them increases the mortality. The connection between higher mortality and PV focuses the attention for the necessity of PV measuring and correction in stroke patients.
