TY  - JOUR
A1  - Rohmann, Jessica L.
A1  - Huo, Shufan
A1  - Sperber, Pia S.
A1  - Piper, Sophie K.
A1  - Rosendaal, Frits R.
A1  - Heuschmann, Peter U.
A1  - Endres, Matthias
A1  - Liman, Thomas G.
A1  - Siegerink, Bob
T1  - Coagulation factor XII, XI, and VIII activity levels and secondary events after first ischemic stroke
JF  - Journal of Thrombosis and Haemostasis
N2  - Background
Though risk for recurrent vascular events is high following ischemic stroke, little knowledge about risk factors for secondary events post‐stroke exists.

Objectives
Coagulation factors XII, XI, and VIII (FXII, FXI, and FVIII) have been implicated in first thrombotic events, and our aim was to estimate their effects on vascular outcomes within 3 years after first stroke.

Patients/Methods
In the Prospective Cohort with Incident Stroke Berlin (PROSCIS‐B) study, we followed participants aged 18 and older for 3 years after first mild to moderate ischemic stroke event or until occurrence of recurrent stroke, myocardial infarction, or all‐cause mortality. We compared high coagulation factor activity levels to normal and low levels and also analyzed activities as continuous variables. We used Cox proportional hazards models adjusted for age, sex, and cardiovascular risk factors to estimate hazard ratios (HRs) for the combined endpoint.

Results
In total, 94 events occurred in 576 included participants, resulting in an absolute rate of 6.6 events per 100 person‐years. After confounding adjustment, high FVIII activity showed the strongest relationship with the combined endpoint (HR = 2.05, 95% confidence interval [CI] 1.28–3.29). High FXI activity was also associated with a higher hazard (HR = 1.80, 95% CI 1.09–2.98), though high FXII activity was not (HR = 0.86, 95% CI 0.49–1.51). Continuous analyses yielded similar results.

Conclusions
In our study of mild to moderate ischemic stroke patients, high activity levels of FXI and FVIII but not FXII were associated with worse vascular outcomes in the 3‐year period after first ischemic stroke.
KW  - coagulation
KW  - factor VIII
KW  - factor XI
KW  - factor XII
KW  - ischemic stroke
Y1  - 2020
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-217877
VL  - 18
IS  - 12
SP  - 3316
EP  - 3324
ER  - 
TY  - JOUR
A1  - Scheitz, Jan F.
A1  - Lim, Jess
A1  - Broersen, Leonie H. A.
A1  - Ganeshan, Ramanan
A1  - Huo, Shufan
A1  - Sperber, Pia S.
A1  - Piper, Sophie K.
A1  - Heuschmann, Peter U.
A1  - Audebert, Heinrich J.
A1  - Nolte, Christian H.
A1  - Siegerink, Bob
A1  - Endres, Matthias
A1  - Liman, Thomas G.
T1  - High‐Sensitivity Cardiac Troponin T and Recurrent Vascular Events After First Ischemic Stroke
JF  - Journal of the American Heart Association
N2  - Background
Recent evidence suggests cardiac troponin levels to be a marker of increased vascular risk. We aimed to assess whether levels of high‐sensitivity cardiac troponin T (hs‐cTnT) are associated with recurrent vascular events and death in patients with first‐ever, mild to moderate ischemic stroke.

Methods and Results
We used data from the PROSCIS‐B (Prospective Cohort With Incident Stroke Berlin) study. We computed Cox proportional hazards regression analyses to assess the association between hs‐cTnT levels upon study entry (Roche Elecsys, upper reference limit, 14 ng/L) and the primary outcome (composite of recurrent stroke, myocardial infarction, and all‐cause death). A total of 562 patients were analyzed (mean age, 67 years [SD 13]; 38.6% women; median National Institutes of Health Stroke Scale=2; hs‐cTnT above upper reference limit, 39.2%). During a mean follow‐up of 3 years, the primary outcome occurred in 89 patients (15.8%), including 40 (7.1%) recurrent strokes, 4 (0.7%) myocardial infarctions, and 51 (9.1%) events of all‐cause death. The primary outcome occurred more often in patients with hs‐cTnT above the upper reference limit (27.3% versus 10.2%; adjusted hazard ratio, 2.0; 95% CI, 1.3–3.3), with a dose‐response relationship when the highest and lowest hs‐cTnT quartiles were compared (15.2 versus 1.8 events per 100 person‐years; adjusted hazard ratio, 4.8; 95% CI, 1.9–11.8). This association remained consistent in sensitivity analyses, which included age matching and stratification for sex.

Conclusions
Hs‐cTnT is dose‐dependently associated with an increased risk of recurrent vascular events and death within 3 years after first‐ever, mild to moderate ischemic stroke. These findings support further studies of the utility of hs‐cTnT for individualized risk stratification after stroke.
KW  - epidemiology
KW  - ischemic stroke
KW  - mortality/survival
KW  - troponin
KW  - vascular disease
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-239039
VL  - 10
IS  - 10
ER  -