Thrombophilias in patients with ischemic stroke. Indication and calculated costs for evidence-based diagnostics and treatment

Der Nervenarzt
R Weber, E Busch

Abstract

Patients with ischemic stroke are sometimes found to have an underlying inherited (deficiency of protein C, protein S, antithrombin III, activated protein C resistance, prothrombin gene mutation, hyperhomocysteinemia) or acquired thrombophilia (lupus anticoagulant and anticardiolipin antibodies, hyperhomocysteinemia). Patient selection for thrombophilia screening is, therefore, a frequent question in managing patients with ischemic stroke. In this review we discuss patient selection and timing for laboratory tests for thrombophilia screening in stroke patients based on a literature review and we calculated overall costs per year in Germany for testing patients older than 18 years with an ischemic stroke of undetermined cause. As there is a lack of studies comparing anticoagulation with antiplatelet therapy in patients with diagnosed thrombophilia, laboratory screening for thrombophilia even in a selected group of patients with cryptogenic ischemic stroke remains of questionable value at present. An exception appears to be testing for lupus anticoagulant and anticardiolipin antibodies in younger patients with suspected antiphospholipid syndrome (two positive test results necessary), because anticoagulation seems to be superior t...Continue Reading

References

Aug 1, 1990·Stroke; a Journal of Cerebral Circulation·R G Hart, M C Kanter
May 1, 1995·Stroke; a Journal of Cerebral Circulation·A LindgrenB B Johansson
Feb 1, 1994·Stroke; a Journal of Cerebral Circulation·F BarinagarrementeriaR Izaguirre
Feb 11, 1998·Journal of Neurology·A G MuntsP J Koudstaal
May 7, 1999·Stroke; a Journal of Cerebral Circulation·B KristensenT Olsson
Jul 9, 1999·Arteriosclerosis, Thrombosis, and Vascular Biology·M MargaglioneG Di Minno
Aug 7, 1999·Lancet·G J Hankey, J W Eikelboom
May 5, 2000·The Cochrane Database of Systematic Reviews·M LiuP Sandercock
Aug 6, 2000·British Journal of Haematology·M GreavesI Mackie
Sep 2, 2000·Journal of Autoimmunity·M Petri
Jan 11, 2000·Stroke; a Journal of Cerebral Circulation·C D Bushnell, L B Goldstein
Jan 4, 2001·Stroke; a Journal of Cerebral Circulation·D J MeiklejohnM Greaves
Jun 9, 2001·The American Journal of Cardiology·A H Wu, G J Tsongalis
Aug 4, 2001·Stroke; a Journal of Cerebral Circulation·G J HankeyR I Baker
Nov 3, 2001·Stroke; a Journal of Cerebral Circulation·A J GrauH C Diener
Nov 8, 2001·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·S LopaciukH Jedrzejowska
Nov 27, 2001·Cerebrovascular Diseases·L OláhL Csiba
Jan 10, 2002·Stroke; a Journal of Cerebral Circulation·Pasquale MadonnaGiovanni Di Minno
Feb 2, 2002·Stroke; a Journal of Cerebral Circulation·Virginia J HowardUNKNOWN Stability of Plasma Homocyst(e)ine in Acute Stroke Patients (SHASP) Study Investigators
Mar 8, 2002·The New England Journal of Medicine·Jerrold S LevineJoyce Rauch
Apr 6, 2002·Stroke; a Journal of Cerebral Circulation·Cheryl D Bushnell, Larry B Goldstein
Apr 16, 2002·Arthritis and Rheumatism·Ricard CerveraUNKNOWN Euro-Phospholipid Project Group
Jun 19, 2002·Blood·Klaus JuulBørge Grønne Nordestgaard
Oct 5, 2002·Stroke; a Journal of Cerebral Circulation·Robin L BreySteven J Kittner
Nov 8, 2002·Archives of Pathology & Laboratory Medicine·Kandice Kottke-Marchant, Alexander Duncan
Nov 8, 2002·Archives of Pathology & Laboratory Medicine·Kandice Kottke-Marchant, Philip Comp
Nov 20, 2002·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·R GrossmannS Schwender
Nov 26, 2002·BMJ : British Medical Journal·David S WaldJoan K Morris
Nov 27, 2002·Neurology·Cheryl D Bushnell, Larry B Goldstein
Dec 7, 2002·Stroke; a Journal of Cerebral Circulation·Harland AustinUNKNOWN Genetics and Stroke in the Young Study Group
Dec 25, 2002·The American Journal of Clinical Nutrition·Raymond MeleadyAnne-Lise Bjorke Monsen

❮ Previous
Next ❯

Related Concepts

Related Feeds

Brain Ischemia

Brain ischemia is a condition in which there is insufficient blood flow to the brain to meet metabolic demand. Discover the latest research on brain ischemia here.

Antiphospholipid Syndrome

Antiphospholipid syndrome or antiphospholipid antibody syndrome (APS or APLS), is an autoimmune, hypercoagulable state caused by the presence of antibodies directed against phospholipids.

Related Papers

JPMA. the Journal of the Pakistan Medical Association
Naveed AkhtarSaadat Kamran
Annales de médecine interne
Jean-François Schved
Current Treatment Options in Neurology
Bradley K. Hiatt, Steven R. Lentz
Neurología : publicación oficial de la Sociedad Española de Neurología
J CachoV Vicente
© 2021 Meta ULC. All rights reserved