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Factor XIII A‐subunit concentration predicts outcome in stroke subjects and vascular outcome in healthy, middle‐aged men
Author(s) -
Kohler Hans P.,
Ariëns Robert A. S.,
Catto Andrew J.,
Carter Angela M.,
Miller George J.,
Cooper Jackie A.,
Mansfield Michael W.,
Standeven Kristina F.,
Grant Peter J.
Publication year - 2002
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.2002.03707.x
Subject(s) - medicine , stroke (engine) , myocardial infarction , vascular disease , cardiology , gastroenterology , factor xiii , coronary artery disease , antigen , immunology , fibrinogen , mechanical engineering , engineering
Summary. There is growing evidence for a role of factor XIII (FXIII) in vascular disease. FXIII measures were determined in (i) a nested case–control study from the Second Northwick Park Heart Study of 63 men with myocardial infarction (MI) and 124 age‐matched controls and (ii) in a case–control study of 475 subjects with acute stroke and 461 controls followed up for 54 months for mortality. In both studies, measures of FXIII A‐ and B‐subunit antigen, FXIII activity and prothrombin fragments (F1 + 2) were made. An in vitro model was used to investigate the effects of thrombin activity on FXIII A‐ and B‐subunit antigen levels. In study 1, patients clinically free of coronary artery disease who later developed MI had lower adjusted FXIII A‐subunit levels at recruitment (129·2% vs 113·3%, P = 0·007). In study 2, stroke patients with large vessel disease had lower A‐subunit antigen levels (102·1% vs 127·2%, P < 0·001), but higher F1 + 2 levels (0·941% vs 0·753%, P < 0·05), than subjects with small vessel disease. Levels of FXIII A‐subunit (100% vs 117%, P < 0·0001) were lower and F1 + 2 higher (1·020% vs 0·702%, P < 0·0001) in stroke patients who had died compared with those still alive at the end of the follow‐up period. Low concentrations of FXIII A‐subunit antigen predicted vascular outcome in otherwise healthy subjects and relate to both size of infarct and poor post‐stroke survival in patients with acute ischaemic stroke. Low in vitro concentrations of FXIII A‐subunit antigen wererelated to increased thrombin generation and, thus, increased risk of thrombotic events.