Assessment of hypercoagulation state in patients with embolic cerebrovascular or transient ischemic attack and patent foramen ovale

ABSTRACT

Patent foramen ovale [PFO] causes a right-to-left shunt in about a quarter of normal population. Hypercoagulation may be a risk factor for embolic cerebrovascular accidents [CVA] in these patients by paradoxical emboli. In this study, we checked hypercoagulation states in the embolic CVA patients with PFO. In a cross- sectional study, 40 patients with CVA or transient ischemic attack [TIA] and PFO participated in the study. Serum level of Homocystein, lupus anticoagulant screening test, Factor V leiden, Anti Cardiolipin Antibody [ACLA] [IgG, IgM], Anti- thrombin III, protein C, protein S,Anti B2 glycoprotein1 and platelet count were checked in all patients. The data were analyzed using the statistical package for social science series [SPSS 15.0] and descriptive statistical method. The mean age was 42.4 +/- 12.1. Seventeen [42.5%] patients were females. Twenty- two [55%] cases were diagnosed as having CVA and the others as TIA. Three [7.5%] of the patients were diabetic and 8 [20%] had a history of different stages of hypertension. Hyperlipidemia was detected in 6 [15%] patients and according to the laboratory data none had any signs of hypercoagulation. According to the present study, hypercoagulation as a cofactor in CVA patients with PFO did not seem to be a direct risk factor for embolic CVA at least any higher than for normal population