2-of-5 young patients with ischemic stroke who underwent thrombophilia screening at an institution had at least 1 positive test but only 1-in-12 had a resultant change in clinical management, according to a recent study. However, neither cryptogenic stroke subtype nor other studied clinical factors were associated with a prothrombotic state. Researchers performed a retrospective cohort study of patients aged 18-65 years diagnosed with acute ischemic stroke at a comprehensive stroke center between 2011 and 2015 with laboratory testing for thrombophilia. The primary outcome was any positive thrombophilia screening test. The secondary outcome was a change in clinical management based on thrombophilia testing results. They found:
- Among 196 young ischemic stroke patients, at least 1 positive thrombophilia test was identified in 85 patients (43%) and 16 (8%) had a resultant change in management.
- Among 111 patients with cryptogenic strokes, 49 (44%) had an abnormal thrombophilia test and 9 (8%) had a change in management.
- Prespecified risk factors were not significantly associated with positive thrombophilia testing or a change in management.
Omran SS, Lerario MP, Gialdini G, et al. Clinical impact of thrombophilia screening in young adults with ischemic stroke. [Published online ahead of print December 27, 2018]. J Stroke Cerebrovasc Dis. doi:10.1016/j.jstrokecerebrovasdis.2018.12.006.