Factor V leiden and prothrombin G20210A mutations may predispose for cerebral infarction

A recent age- and sex-matched paired case-control study comparing patients suffering from cerebral infarction with and without patent foramen ovale (PFO) revealed that the occurence of factor V leiden and, to a lesser extent, of prothrombin G20210 A mutation is a clinically relevant risk for the development of cerebral infarction in association with PFO.

Berhard Stephan and his team at the University Hospitals of Saarland, Homburg (Germany) studied a total of 92 patients with ischemic stroke, 46 individuals with and 46 without patent foramen ovale (PFO). The frequency of factor V leiden was 2.1 fold higher in PFO patients than in subjects without PFO which was significant. Prothrombin mutation in PFO patients was observed in 3 versus 1 case which was not significant. Combined presence of these two kinds of mutations was not observed in any of the cases.

Due to the close relationship of these markers with the formation of venous thrombosis, the data provide further evidence that paradoxical embolism is obviously an essential mechanism for developing stroke in PFO patients. Stephan et al., in their report published in Applied Cardiopulmonary Pathophysiology 16 (No 1-2012), suggest to perform additional examinations of the peripheral venous system in stroke patients with PFO and inherited thrombophilia – apart from neurological and cardiologic diagnosis.