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(Stroke. 1997;28:816-821.)
© 1997 American Heart Association, Inc.


Articles

Polymorphisms of the Factor VII Gene and Circulating FVII:C Levels in Relation to Acute Cerebrovascular Disease and Poststroke Mortality

Daniella M. Heywood, BSc; Angela M. Carter, BSc; Andrew J. Catto, MRCP; John M. Bamford, MD, FRCP Peter J. Grant, MD, FRCP

From the Unit of Molecular Vascular Medicine, Division of Medicine, School of Medicine, University of Leeds, and the Department of Neurology, St James' University Hospital (J.M.B.), Leeds, UK.

Correspondence to Daniella Heywood, Unit of Molecular Vascular Medicine, Division of Medicine, G Floor, Martin Wing, Leeds General Infirmary, Leeds, LS1 3EX UK. E-mail daniellh{at}pathology.leeds.ac.uk

Background and Purpose FVII:C has been shown to be an independent risk factor for myocardial infarction and is related to environmental and genetic factors. This study sought to investigate FVII:C levels and factor VII (FVII) gene polymorphisms in relation to stroke and disease outcome.

Methods To examine the association of FVII:C and the Msp I and promoter insertion polymorphisms of the FVII gene in acute stroke, 317 patients and 198 age-matched control subjects were studied.

Results FVII:C levels were significantly lower in patients at onset than 3 months later (119% versus 135%, respectively; P<.0005). Levels were significantly lower in patients at onset than in control subjects (124% [95% confidence interval, 120% to 129%] versus 141% [95% confidence interval, 135% to 148%], respectively; P<.0005) but were not significantly different at 3 months (135% [95% confidence interval, 128% to 141%] versus 141% [95% confidence interval, 135% to 148%], respectively). We found no difference in genotype distribution for either polymorphism between patients and control subjects, no difference in FVII:C level or genotype distribution between pathological types of stroke, and no relationship with poststroke mortality. Both polymorphisms were significantly associated with FVII:C levels in patients and control subjects. In a multiple regression model for patients, Msp I genotype, cholesterol, and smoking remained as independent predictors of FVII:C levels, accounting for 32% of interindividual variation.

Conclusions These results suggest that neither FVII:C levels nor FVII gene polymorphisms are associated with cerebrovascular disease. There were no genotype-specific correlations of environmental factors with FVII:C, but there was evidence of an acute-phase or consumptive fall in FVII:C levels at the time of stroke, whereas levels increased to those similar for healthy age-matched control subjects by 3 months, when the acute phase had presumably subsided.


Key Words: coagulation • polymorphism (genetics) • stroke, acute




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