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dc.contributor.authorMorris, Jane G.
dc.contributor.authorSingh, Swaraj
dc.contributor.authorFisher, Marc
dc.date2022-08-11T08:09:28.000
dc.date.accessioned2022-08-23T16:31:44Z
dc.date.available2022-08-23T16:31:44Z
dc.date.issued2010-12-16
dc.date.submitted2011-03-17
dc.identifier.citationStroke. 2010 Dec;41(12):2985-90. Epub 2010 Oct 14. <a href="http://dx.doi.org/10.1161/STROKEAHA.110.595199">Link to article on publisher's site</a>
dc.identifier.issn0039-2499 (Linking)
dc.identifier.doi10.1161/STROKEAHA.110.595199
dc.identifier.pmid20947844
dc.identifier.urihttp://hdl.handle.net/20.500.14038/37720
dc.description.abstractBACKGROUND AND PURPOSE: Despite a paucity of evidence supporting a true association of ischemic stroke and the inherited thrombophilias, it is common practice for many neurologists to order these tests as part of the work-up of ischemic stroke, especially in young patients. Treatment with oral anticoagulation is often used in patients with positive results for the inherited thrombophilias. METHODS: We reviewed the literature focusing on case-control studies of the 5 most commonly inherited disorders of coagulation: protein C deficiency, protein S deficiency, antithrombin deficiency, and the factor V Leiden and prothrombin gene mutations in patients with stroke. We also analyzed the available data on stroke patients with inherited thrombophilia and patent foramen ovale. RESULTS: Multiple case-control studies have not convincingly shown an association of the inherited thrombophilias with ischemic stroke, even in young patients and patients with patent foramen ovale. CONCLUSIONS: If there is an association between the inherited thrombophilias and arterial stroke, then it is a weak one, likely enhanced by other prothrombotic risk factors. The consequences of ordering these tests and attributing causality to an arterial event can result in significant costs to the health care system and pose a potential risk to patients, because this may lead to inappropriate use of long-term oral anticoagulants, exposing patients to harm without a clearly defined benefit.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=20947844&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1161/STROKEAHA.110.595199
dc.subjectAntithrombin III Deficiency
dc.subjectBrain Ischemia
dc.subjectCase-Control Studies
dc.subjectCost-Benefit Analysis
dc.subjectFactor V Deficiency
dc.subjectForamen Ovale, Patent
dc.subjectHumans
dc.subjectProtein C Deficiency
dc.subjectProtein S Deficiency
dc.subjectStroke
dc.subjectThrombophilia
dc.subjectNeurology
dc.subjectNeuroscience and Neurobiology
dc.titleTesting for inherited thrombophilias in arterial stroke: can it cause more harm than good
dc.typeJournal Article
dc.source.journaltitleStroke; a journal of cerebral circulation
dc.source.volume41
dc.source.issue12
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/neuro_pp/396
dc.identifier.contextkey1884001
html.description.abstract<p>BACKGROUND AND PURPOSE: Despite a paucity of evidence supporting a true association of ischemic stroke and the inherited thrombophilias, it is common practice for many neurologists to order these tests as part of the work-up of ischemic stroke, especially in young patients. Treatment with oral anticoagulation is often used in patients with positive results for the inherited thrombophilias.</p> <p>METHODS: We reviewed the literature focusing on case-control studies of the 5 most commonly inherited disorders of coagulation: protein C deficiency, protein S deficiency, antithrombin deficiency, and the factor V Leiden and prothrombin gene mutations in patients with stroke. We also analyzed the available data on stroke patients with inherited thrombophilia and patent foramen ovale.</p> <p>RESULTS: Multiple case-control studies have not convincingly shown an association of the inherited thrombophilias with ischemic stroke, even in young patients and patients with patent foramen ovale.</p> <p>CONCLUSIONS: If there is an association between the inherited thrombophilias and arterial stroke, then it is a weak one, likely enhanced by other prothrombotic risk factors. The consequences of ordering these tests and attributing causality to an arterial event can result in significant costs to the health care system and pose a potential risk to patients, because this may lead to inappropriate use of long-term oral anticoagulants, exposing patients to harm without a clearly defined benefit.</p>
dc.identifier.submissionpathneuro_pp/396
dc.contributor.departmentDepartment of Neurology
dc.source.pages2985-90


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