Table of Contents
Volume 2014, Article ID 302861, 6 pages
Research Article

New Thrombotic Events in Ischemic Stroke Patients with Elevated Factor VIII

1Stroke Program, Department of Neurology, Tulane University School of Medicine, 1440 Canal Street, TB-52, Suite 1000, New Orleans, LA 70112-2715, USA
2Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, 630 West 168 Street, New York, NY 10032, USA
3Stroke Program, Department of Neurology, Hospital of the University of Pennsylvania, 3400 Spruce Street, 2nd Floor, Ravdin Building, Philadelphia, PA 19104, USA
4Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL 35294, USA
5Health Services and Outcomes Research Center for Outcome and Effectiveness Research and Education (COERE), 1530 3rd Avenue South, Medical Towers, Birmingham, AL 35294, USA
6Center of Excellence in Comparative Effectiveness Research for Eliminating Disparities (CERED), Medical Towers Building, 1717 11th Avenue South, Suite 516A, Birmingham, AL 35294, USA
7Section on Statistical Genetics, Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL 35294, USA
8Section of Hematology/Oncology, Department of Medicine, Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, LA, USA

Received 19 September 2014; Revised 22 November 2014; Accepted 22 November 2014; Published 17 December 2014

Academic Editor: Domenico Prisco

Copyright © 2014 Brittany M. Gouse et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Heightened levels of Factor VIII (FVIII) have been associated with both arterial and venous thrombosis. While elevated FVIII is common during acute ischemic stroke (AIS), whether elevated FVIII confers an increased risk for recurrent thrombotic events (RTEs) following AIS has not been previously explored. Methods. Consecutive AIS patients who presented to our center between July 2008 and September 2013 and had FVIII measured during admission were identified from our stroke registry. Baseline characteristics and the occurrence of RTE (recurrent or progressive ischemic stroke, DVT/PE, and MI) were compared in patients with and without elevated FVIII levels. Results. Of the 298 patients included, 203 (68.1%) had elevated FVIII levels. Patients with elevated FVIII had higher rates of any in-hospital RTE (18.7% versus 8.4%, ). This association remained after adjustment for baseline stroke severity and etiology (OR 1.01, 95% CI 1.00–1.01, ). Rates of major disability were also higher in patients who experienced a RTE (17.8% versus 3.2%, ). Conclusion. A significantly higher frequency of in-hospital RTEs occurred in AIS patients with elevated FVIII. The occurrence of such events was associated with higher morbidity. Further study is indicated to evaluate whether FVIII is a candidate biomarker for increased risk of RTEs following AIS.