London, United Kingdom 2013 Poster Session Red Cerebrovasc Dis 2013; 35 (suppl 3)1-854 421 254 Etiology of stroke and risk factors Withdrawn! 255 Etiology of stroke and risk factors Risk of myocardial infarction and ischaemic stroke and the impact of hypercoagulability - the RATIO case control study B. Siegerink1, A. Maino2, F.R. Rosendaal3, A. Algra4 Leiden unversity medical center, Leiden, THE NETHERLANDS1, Università degli Studi di Mi-lano, Milan, ITALY2, Leiden unversity medical center, Leiden, THE NETHERLANDS3, University Medical Center Utrecht, Utrecht, THE NETHERLANDS4 Background - Myocardial infarction (MI) and ischaemic stroke (IS) are both acute forms of arterial thrombosis. Some risk factors are shared, but others are not, indicating possible different pathophys-iological mechanisms. This study aims to determine whether measures of hypercoagulability have a comparable impact on the risk of MI and IS. Methods - The RATIO study is a case control study involving young women (<50 years) with MI, non-cardioembolic ISand healthy controls. To compare the impact of prothrombotic factors we cal-culated relative odds ratios (ORIS/ORMI) and their corresponding confidence intervals based on published results. Additionally, we calculated population attributable fractions (prevalence in cases *(OR-1/OR)), which reflect the fraction of cases prevented if the exposure were to be eliminated from the general population. Results - In total, 30 prothrombotic risk factors were identified as measures of hypercoagulability (see figure). The population attributable fractions show that measures of hypercoagulability have a bigger impact on IS risk than for MI. Twenty-one of these risk factors have a relative odds ratios >1, 14 >2, and 6 > 2.75 being high levels of activated FXI and FXII, combination of oral contraceptive use and factor V Leiden trait, the presence of lupus anticoagulans, and a single nucleotide polymor-phism in the gene coding for coagulation factor XIII. Discussion - Overall, prothrombotic factors have a bigger impact on the risk of IS that than of MI, suggesting a different role of hypercoagulability in the underlying mechanism of these two diseases. The results from the RATIO study are subject to potential sources of these biases, such as reverse causation and residual confounding. However, because we compare results within a single study, the impact of this bias is similar for the MI and IS analyses and therefore cannot explain the observed contrast.
Karger_ESC London_2013
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