Abstract T P190: A Model for Predicting Persistent Elevation of Factor VIII Among Patients with Acute Ischemic Stroke (AIS)
Background and Purpose: Recent studies have demonstrated that elevated levels of coagulation factor VIII (FVIII), a risk factor for stroke, may persist independent of the acute-phase response; however, this relationship has not yet been investigated in the context of acute ischemic stroke (AIS). We sought to determine 1) the proportion of AIS patients with acutely elevated serum FVIII levels who had persistently elevated FVIII levels in the outpatient setting and 2) the characteristics at baseline predictive of persistently elevated FVIII levels.
Methods: From our stroke registry, patients diagnosed with AIS between 07/2008-05/2014 were included if the initial FVIII level was elevated and a repeat FVIII level was obtained. A score was developed to predict which patients are at the greatest odds of remaining persistently elevated at both the 150% and 200% thresholds.
Results: Among 1,616 AIS cases, 106 patients had initially elevated FVIII levels and repeat FVIII levels obtained. A total of 82.7% of patients had persistent elevation at the 150% threshold and 75.7% had persistent elevation at the 200% threshold. Time from initial FVIII measurement to second FVIII measurement was not different between the two groups (p=0.054). According to the models developed, for every one-point increase in the score, an individual is at ten-fold increased odds to have persistently elevated FVIII at both the 150% threshold (OR=10.43, 95% CI 1.63-66.9, p=0.0134) and 200% threshold (OR=10.2, 95% CI 1.82-57.5, p=0.0083).
Conclusions: Persistent elevation in FVIII is common and in most AIS patients likely represents a constitutional risk factor. Persistent elevation in FVIII can be predicted by baseline characteristics in the setting of AIS, potentially proving useful in identifying patients at high risk for developing subsequent stroke.
Author Disclosures: A.A. Samai: None. A.K. Boehme: None. A. Shaban: None. A. George: None. D.J. Monlezun: None. L. Dowell: None. C. Leissinger: None. L. Schluter: None. R. El Khoury: None. S. Martin-Schild: Research Grant; Modest; Pilot Grant from Tulane University School of Medicine.
- © 2015 by American Heart Association, Inc.