VON-WILLEBRAND-FACTOR AND RISK OF ISCHEMIC STROKE

We carried out a case-control study to determine whether von Willebran d factor (VWF) antigen (and factor VII and tissue plasminogen activato r [tPA] antigens) are associated with ischemic stroke. Ninety-five pat ients with transient ischemic attack or minor ischemic stroke recruite d from the Oxfordshire Community Stroke Project and one neurology clin ic were compared with 236 controls, group-matched for age and sex, fro m the same general practitioners as the incident cases. In crude analy ses, concentrations of vWF antigen were significantly higher in cases than in controls (p = 0.004). The age-and sex-adjusted odds ratios fro m lowest (referent) to highest quartile of VWF antigen were 1.00, 1.15 , 2.34, and 2.36. (trend test, p = 0.006). Factor VII antigen and tPA antigen were not significantly different between cases and controls. A lthough adjustment for other potential risk factors abolished the stat istical significance of the association between vWF and disease, this was largely due to the influence of history of ischemic heart disease. We conclude that VWF is a potent and independent risk factor for tran sient ischemic attack, minor ischemic stroke, and, by extrapolation, i schemic stroke in general. The data also suggest that vWF may be a ris k factor for both ischemic stroke and ischemic heart disease. We found no evidence to implicate factor VII and tPA as risk factors for ische mic stroke.