POLYMORPHISMS OF THE FACTOR-VII GENE AND CIRCULATING FVII-C LEVELS INRELATION TO ACUTE CEREBROVASCULAR-DISEASE AND POSTSTROKE MORTALITY

Background and Purpose FVII:C has been shown to be an independent risk factor for myocardial infarction and is related to environmental and genetic factors. This study sought to investigate FVII:C levels and fa ctor VII (FVII) gene polymorphisms in relation to stroke and disease o utcome, Methods To examine the association of FVII:C and the Msp I and promoter insertion polymorphisms of the FVII gene in acute stroke, 31 7 patients and 198 age-matched control subjects were studied. Results FVII:C levels were significantly lower in patients at onset than 3 mon ths later (119% versus 135%, respectively; P<.0005), Levels were signi ficantly lower in patients at onset than in control subjects (124% [95 % confidence interval, 120% to 129%] versus 141% [95% confidence inter val; 135% to 148%], respectively; P<.0005) but were not significantly different at 3 months (135% [95% confidence interval, 128% to 141%] ve rsus 141% [95% confidence interval, 135% to 148%], respectively). We f ound no difference in genotype distribution for either polymorphism be tween patients and control subjects, no difference in FVII:C level or genotype distribution between pathological types of stroke, and no rel ationship with poststroke mortality, Both polymorphisms were significa ntly associated with FVII:C levels in patients and control subjects, I n a multiple regression model for patients, Msp I genotype, cholestero l, and smoking remained as independent predictors of FVII:C levels, ac counting for 32% of interindividual variation. Conclusions These resul ts suggest that neither MI:C levels nor FVII gene polymorphisms are as sociated with cerebrovascular disease. There were no genotype-specific correlations of environmental factors with FVII:C, but there was evid ence of an acute-phase or consumptive fall in FVII:C levels at the tim e of stroke, whereas levels increased to those similar for healthy age -matched control subjects by 3 months, when the acute phase had presum ably subsided.