Abstract T P155: The Vascular Distribution of Stroke Among Patients with Hypercoagulable State
Background: Hypercoagulable state (HCS) may increase the risk for acute ischemic stroke (AIS). The relationship between HCS and the location of the stroke has never been described.
Objective: To determine if HCS is associated with an increased the frequency of strokes in specific vascular distributions.
Methods: Patients who consecutively presented to our center with AIS between 06/2008-09/2013 were selected from our prospective stroke registry. Patients who did not receive HCS blood tests were excluded from the analysis. Diffusion weighted MRI sequences were used to identify the vascular distribution of each stroke.
Results: Among the 1,466 AIS cases presented during the study period, 395 AIS patients met our inclusion criteria; 187 patients had an HCS (77.4% Black, 51.4% Female, 55 years median age); 208 patients did not have an HCS (60.4% Black, 42.3% Female, 56 years median age). There was no significant difference in the frequency of anterior circulation strokes (p=0.130) or posterior circulation strokes (p=0.060) between the groups. Patient with HCS were more likely to have a stroke in the posterior inferior cerebellar artery (PICA) territory (9.1% vs. 2.1%, p=0.001). After adjusting to the stroke subtype, patients with HCS were at nearly 5 times higher odds of having a PICA stroke (OR=4.47, 95%CI 1.42-14.1, p=0.010). The two groups did not differ in the frequency of anterior, middle or posterior cerebral artery strokes. We did not detect a significant difference in the vertebral artery, basilar artery or anterior inferior cerebellar artery strokes.
Conclusion: In our sample, hypercoagulable state was associated with significantly higher frequency of PICA territory strokes. Patients with PICA distribution stroke and no cardiac or large vessel etiology identified might benefit from expanding the work-up to include hypercoagulation studies.
Author Disclosures: A. Shaban: None. A.K. Boehme: None. M. Ryan: None. K.C. Albright: None. R. El Khoury: None. S. Martin-Schild: None.
- © 2015 by American Heart Association, Inc.