SCREENING FOR THE FACTOR-V ARG 506 GLN MUTATION IN PATIENTS WITH TIA AND STROKE

A common point mutation in the factor-V gene at the exact site (Arg 50 6) where activated protein C (APC) normally cleaves and inactivates th e Va procoagulant accounts for APC resistance and is the most importan t genetic risk factor for venous thrombosis. It has also been suggeste d as a possible risk factor fur stroke. We determined the prevalence o f the Arg 506 Gin mutation in 180 patients (mean age 65.3 years) with cerebrovascular disease (138 stroke and 42 TIA) and compared it with t hat in 70 age-matched controls (mean age 64.9 years). The mutation was no more common in patients than controls [15/180 (8.3%) vs. 5/70 (7.1 %), p = 0,6]. Within the patient group there was no relationship betwe en the presence. of the mutation and age of stroke or the occurrence o f TLA or stroke. There was no association between the mutation and any particular stroke subtype (large-vessel, lacunar, cardioembolic or un known). The factor-V Arg 506 Gln mutation is not an important risk fac tor for stroke and TIA in an unselected group of patients, and routine screening is not justified.