The importance of prothrombotic mutations ischemic stroke in patients under 45 years of age

Ischemic stroke is a complex and multifactorial disorder which is seen more frequently by age and affected from genetical and environmental factors. When one take into consideration the life and socio-economical disabilities caused by stroke, studies which target to decrease the prevalance and incidence of stroke via determining the stroke risc factors constitue an important base. Of the whole stroke cases, 4 – 10 percent is seen among the young people. It is very hard to determine the real frequency of the stroke ethiology in youngs. In various studies, large differencies were observed in reasons of the stroke ethiology. Ethiological factors are more heterogeneous in young patients with ischemic stroke, when compared with the older age populations and the real cause can not be found in 15 – 40 percent of all cases. In recent past, it has been reported that prothombic gene mutations could be a risc factor for the ischemic stroke in young people. However, the role of these mutations in both ischemic and hemorrhagic stroke types is a controversial issue. Although it has been proposed in many casecontrolled studies that there was a positive correlation between the prothrombic gene mutation and stroke, this has not been confirmed by the large scaled case control studies yet. Insufficient sample size, diversity of the ethnic groups and methods might contribute to the difference in the reported results. Most of the studies conducted before have been focused on FV Leiden, MTHFR C677T and G20210A mutations. To the best of our knowledge, there is a very little number of studies in which the frequency of the multiple mutations of prothrombic gene polymorphisms is investigated in young patients with ischemic stroke. The aim of this study was to investigate the frequency of the multiple prothrombic gene mutations such as Factor V Leiden (G1691A) and Factor V H1299R, MTHFR C677T and MTHFR A1298C, Prothrombin G20210A, PAI-1 4G/4G and PAI-1 4G/5G in young patients with ischemic stroke, with respect to the control group. 93 young patients under 45 with ischemic stroke and 43 healthy control individuals were included in this study. Interestingly, we have found some prothrombic mutations more frequently in the control group. These findings have indicated again that the effect of prothrombic gene mutations still remains its enigma in the ethiopathogenesis of ischemic stroke and further more detailed studies are required.