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(Stroke. 1996;27:1163-1166.)
© 1996 American Heart Association, Inc.

Articles

Activated Protein C Resistance in Ischemic Stroke Not Due to Factor V Arginine⁵⁰⁶Glutamine Mutation

Mark Fisher, MD; Jose A. Fernandez, MD, PhD; Sebastian F. Ameriso, MD; Dangci Xie, MD, PhD; Andras Gruber, MD; Annlia Paganini-Hill, PhD John H. Griffin, PhD

the Departments of Neurology (M.F., S.F.A., D.X.) and Preventive Medicine (A.P.-H.), University of Southern California School of Medicine (Los Angeles), and the Departments of Molecular and Experimental Medicine and of Vascular Biology, The Scripps Research Institute, La Jolla, Calif (J.A.F., A.G., J.H.G.).

Correspondence to Mark Fisher, MD, Department of Neurology, University of Southern California School of Medicine, 1333 San Pablo St, MCH 246, Los Angeles, CA 90033. E-mail mjfisher@hsc.usc.edu.

Background and Purpose Resistance to activated protein C (APC), a natural plasma anticoagulant, is the most common identifiable risk factor for venous thromboembolic disease. One point mutation in coagulation factor V that renders it APC-resistant is found in >90% of APC-resistant venous thrombosis patients. To determine the prevalence of APC resistance and of this factor V mutation in stroke, we screened a group of ischemic stroke patients.

Methods Hispanic ischemic stroke patients were screened using two different activated partial thromboplastin time-based assays. One assay using neat patient plasma determined APC resistance, and the other assay using patient plasma diluted into factor V-deficient plasma determined APC-resistant factor V, including the Arg⁵⁰⁶Gln mutation. Results were compared with those in 31 Hispanic control subjects of similar ages.

Results Six of 63 (9.5%) stroke patients had APC resistance compared with none of 31 (0%) control subjects. No patient or control subject had APC-resistant factor V, ie, the factor V Arg⁵⁰⁶Gln mutation.

Conclusions In Hispanic patients with ischemic stroke, the incidence (approximately 10%) of APC resistance is not caused by the factor V Arg⁵⁰⁶Gln mutation. APC resistance not caused by this factor V mutation may be a risk factor for ischemic stroke in this population.

Key Words: cerebral ischemia • Hispanic Americans • protein C • thrombosis

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