Abstract
The molecular epidemiology of stroke is critically lacking in the developing world. We explored the relationships between genetics polymorphism and risk for ischemic stroke among the residents of Casablanca, Morocco. Ninety-one stroke patients matched 1:2 for their age, gender, and ethnic background to 182 healthy controls who were genotyped for the prothrombin G20210A mutation and factor V (FV) Leiden and were assessed for conventional risk factors for stroke. No significant association was found between prothrombin gene mutation with stroke (p = .054). Regarding stroke subtypes, significant relationships between patients with a large artery disease subtype of stroke and this mutation was found compared to controls (p = .046). As a genetic risk factor to develop this event, a strong association was observed when adjusted for conventional vascular risk factors (adjusted OR, 4.3; p = .029). No FV Leiden was found. We suggest that prothrombin mutation but not FV Leiden should be considered as a modest genetic risk factor for large artery disease stroke subtype in the Moroccan population.
Similar content being viewed by others
References
Adams HP Jr, Bendixen BH, Kappelle LJ et al (1993) Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke 24:35–41
Arruda V, Annichino-Bizzacchi JM, Gonçalves MS (1997) Prevalence of the prothrombin gene variant (nt20210A) in venous thrombosis and arterial disease. Thromb Haemost 78:1430–1433
Arruda VR, Siquiera LH, Chiaparini LC (1998) Prevalence of the prothrombin gene variant 20210 G → A among patients with myocardial infarction. Cardiovasc Res 37:42–45
Bertina RM, Koeleman BPC, Koster T et al (1994) Mutation in blood coagulation factor V associated with resistance to activated protein C. Nature 369:64–67
Caprini JA, Glase CJ, Anderson CB, Hathaway K (2004) Laboratory markers in the diagnosis of venous thromboembolism. Circulation 109:14–18
Casas JP, Hingorani AD, Bautista LE, Sharma P (2004) Meta-analysis of genetic studies in ischemic stroke: thirty-two genes involving approximately 18,000 cases and 58,000 controls. Arch Neurol 61:1652–1662
Catto A, Carter A, Ireland H (1995) Factor V Leiden gene mutation and thrombin generation in relation to the development of acute stroke. Arterioscler Thromb Vasc Biol 15:783–785
Cavalli Sforza LL, Piazza A, Menozzi P, Montain J (1988) Reconstruction of human evolution: bringing together genetic, archaeological and linguistic data. Proc Natl Acad Sci U S A 85:6002–6006
Croft SA, Daly ME, Steeds RP (1999) The prothrombin 20210A allele and its association with myocardial infarction. Thromb Haemost 81:861–864
Danneberg J, Abbes AP, Bruggeman BJ et al (1998) Reliable genotyping of the G-20210A mutation of coagulation factor II (prothrombin). Clin Chem 44:349–351
Ferrerasi P, Marchetti G, Legnani E (1997) The heterozygous 20210 G/A prothrombin genotype is associated with early venous thrombosis in inherited thrombophilias and is not increase in frequency in artery disease. Arterioscler Thromb Vasc Biol 17:2418–2422
Gandrille S, Alhenc-Gelas M, Aiach M (1995) A rapid screening method for the factor V Arg → Gln mutation. Blood Coagul Fibrinolysis 6:245
Hankey GJ, Eikelboom JW, Van Bockxmeer FM (2001) Inherited thrombophilia in ischemic stroke and its pathogenic subtypes. Stroke 321:1793–1799
Ioannidis JP, Ntzani EE, Trikalinos TA (2004) Racial differences in genetic effects for complex diseases. Nat Genet 36:1243–1244
Kim RJ, Becker RC (2003) Association between factor V Leiden, prothrombin G20210A, and methylenetetrahydrofolate reductase C677T mutations and events of the arterial circulatory system: a meta-analysis of published studies. Am Heart J 146:948–5
Longstreth WT Jr, Rosendaal FR, Siscovick DS et al (1998) Risk of stroke in young women and two prothrombotic mutations: factor V Leiden and prothrombin gene variant (G20210A). Stroke 29:577–580
Madonna P, de Stefano V, Coppola A (2002) Hyperhomocysteinemia and other inherited prothrombotic conditions in young adults with a history of ischemic stroke. Stroke 33:51–56
Margaglione M, D’Andrea G, Giuliani N et al (1999) Inherited prothrombotic conditions and premature ischemic stroke: sex difference in the association with factor V Leiden. Arterioscler Thromb Vasc Biol 19:1751–1756
Markus HS (2003) Stroke genetics clinical neuroscience. Oxford University Press, New York
Mathonnet F, Nadifi S, Serazin-Leroy V, Dakouane M, Giudicelli Y (2002) Absence of factor V Leiden mutation and low prothrombin G 20210 A mutation prevalence in a healthy Moroccan population. Thromb Haemost 6(88):1073–1074
Meseguer E, Llamas P, Fernandez de Velasco J et al (2004) Prothrombotic factors in stroke. Neurologia 19:99–105
Miller SA, Dykes DD, Polesky HF (1988) A simple salting out procedure for extracting DNA from human nucleated cells. Nucleic Acids Res 16:1215
Poort SR, Rosendaal FR, Reitsma PH, Bertina RM (1996) A common genetic variation in the 3′-untranslated region of the prothrombin gene is associated with elevated plasma prothrombin levels and an increase in venous thrombosis. Blood 88:3698–3703
Press RD, Liu XY, Beamer N (1996) Ischemic stroke in the elderly: role of the common factor V Leiden mutation causing resistance to activated protein C. Stroke 27:44–48
Putaala J, Metso AJ, Metso TM et al (2009) Analysis of 1008 consecutive patients aged 15 to 49 with first-ever ischemic stroke: the Helsinki young stroke registry. Stroke 40:1195–1203
Ridker PM, Hennekens CH, Lindpainter K, Stampfer MJ, Eisenberg PR, Miletich JP (1995) Mutation in the gene coding for coagulation factor V and the risk of myocardial infarction, stroke and venous thrombosis in apparently healthy men. N Engl J Med 33:2912–2917
Ridker PM, Hennekens CH, Miletich JP (1999) G20210A mutation in prothrombin gene and risk of myocardial infarction, stroke, and venous thrombosis in a large cohort of US men. Circulation 99:999–1004
Rosendaal FR, Siscovick DS, Schwartz SM (1997) A common prothrombin variant (20210 G to A) increases the risk of myocardial infarction in young women. Blood 90:1747–1750
Szolnoki Z, Somogyvari F, Kondacs A, Szabo M, Fodor L (2002) Evaluation of the interactions of common genetic mutations in stroke subtypes. J Neurol 249:1391–1397
Voetsch B, Damasceno BP, Camargo ECS et al (2000) Inherited thrombophilia as a risk factor for the development of ischemic stroke in young adults. Thromb Haemost 83:229–233
Webster MWI, Smith HJ, Sharpe DN et al (1988) Patent foramen ovale in young stroke patients. Lancet 332:11–12
Zenz W (1998) Factor V Leiden and prothrombin gene G 20210 A variant in children with ischemic stroke. Thromb Haemost 80:763–766
Zhang F, Wang Y, Deng HW (2008) Comparison of population-based association study methods correcting for population stratification. PLoS ONE 3:3392
Acknowledgments
This study was supported by the Hassan II Academy of Science and Technology. We thank the population which readily wanted to lend itself to our study. We thank the Belgian Technical Cooperation (BTC) in the Democratic Republic of Congo for their support.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
They-They, T.P., Battas, O., Slassi, I. et al. Prothrombin G20210A and Factor V Leiden Polymorphisms in Stroke. J Mol Neurosci 46, 210–216 (2012). https://doi.org/10.1007/s12031-011-9580-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12031-011-9580-9