{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:32:01Z","timestamp":1787790721698,"version":"build-2784847793"},"reference-count":38,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Stroke Vasc Neurol"],"accepted":{"date-parts":[[2018,8,17]]},"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Approximately 40% of strokes in young adults are cryptogenic. The diagnostic yield of thrombophilia screening remains controversial. We aimed to determine utility of current thrombophilia testing for young patients with stroke and transient ischaemic attack (TIA).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We present a retrospective review of all patients with stroke and TIA \u226460 years presenting to University College London Hospital stroke unit and daily TIA clinic from 1 January 2015 to 1 August 2016. Consecutive clinical records and thrombophilia tests, including factor V Leiden (FVL), prothrombin G20210A mutation (PGM), antiphospholipid antibody (APA), and protein S, C and antithrombin (AT) levels, were reviewed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The mean age of 628 patients with stroke and TIA was 49.1\u2009years (SD 9.2). Thrombophilia testing was performed in 360 (57%) patients, including 171 with stroke and 189 with TIA. Positive tests were found in 50 (14%) patients, of whom 24 patients were &lt;50\u2009years. Positive results were found in 36 (10%) with acute ischaemic stroke, 4 (1%) with haemorrhagic stroke and 10 (3%) with TIA. Thirteen patients (4%) had homozygous\/heterozygous FVL or PGM, and 27 (7.5%) had positive APA (anticardiolipin antibody, anti-\u03b22 glycoprotein antibody or lupus anticoagulant). Of 27 (7.5%) patients with protein C, S or AT deficiency, 10 (2.8%) had primary deficiency, presumed hereditary with other secondary causes excluded. 9% of patients with protein C, S or AT and 27% with APA were followed by confirmatory testing.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Thrombophilia testing was positive in only 14% of cases overall. Thrombophilia mutations and protein C, S or AT abnormalities were found rarely and were very uncommon in patients with TIA. Follow-up of abnormal results was generally poor for all groups, which further limited the impact of the thrombophilia testing policy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/svn-2018-000169","type":"journal-article","created":{"date-parts":[[2018,9,12]],"date-time":"2018-09-12T10:45:34Z","timestamp":1536749134000},"page":"231-236","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":26,"title":["Utility of current thrombophilia screening in young patients with stroke and TIA"],"prefix":"10.1136","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1661-4280","authenticated-orcid":false,"given":"Vafa","family":"Alakbarzade","sequence":"first","affiliation":[{"name":"Hyper-acute Stroke Unit, University College London Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Taylor","sequence":"additional","affiliation":[{"name":"Department of Haematology, University College London Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Scully","sequence":"additional","affiliation":[{"name":"Department of Haematology, University College London Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Simister","sequence":"additional","affiliation":[{"name":"Hyper-acute Stroke Unit, University College London Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arvind","family":"Chandratheva","sequence":"additional","affiliation":[{"name":"Hyper-acute Stroke Unit, University College London Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,9,12]]},"reference":[{"key":"2025081709412584000_3.4.231.1","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1001\/jamaneurol.2013.575","article-title":"Ischemic stroke and transient ischemic attack in young adults: risk factors, diagnostic yield, neuroimaging, and thrombolysis","volume":"70","author":"Ji","year":"2013","journal-title":"JAMA Neurol"},{"key":"2025081709412584000_3.4.231.2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.529883"},{"key":"2025081709412584000_3.4.231.3","first-page":"368","article-title":"Thrombophilia","volume":"41","author":"Weston-Smith","year":"1989","journal-title":"Br J Hosp Med"},{"key":"2025081709412584000_3.4.231.4","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-985755"},{"key":"2025081709412584000_3.4.231.5","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2002-01-0111"},{"key":"2025081709412584000_3.4.231.6","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.121636"},{"key":"2025081709412584000_3.4.231.7","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200767100-00005"},{"key":"2025081709412584000_3.4.231.8","first-page":"155","article-title":"Plasma antithrombin III deficiency in ischaemic stroke in the young","volume":"47","author":"Nagaraja","year":"1999","journal-title":"Neurol India"},{"key":"2025081709412584000_3.4.231.9","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2006-08-040774"},{"issue":"Suppl 1","key":"2025081709412584000_3.4.231.10","doi-asserted-by":"crossref","first-page":"S5","DOI":"10.1097\/00001721-199401000-00002","article-title":"An overview of the mechanism of action of antithrombin and its inherited deficiency states","volume":"5","author":"Blajchman","year":"1994","journal-title":"Blood Coagul Fibrinolysis"},{"key":"2025081709412584000_3.4.231.11","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1161\/str.23.2.1532868","article-title":"Stroke and familial protein S deficiency","volume":"23","author":"G\u00f3mez-Aranda","year":"1992","journal-title":"Stroke"},{"key":"2025081709412584000_3.4.231.12","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1016\/S0140-6736(00)04218-5","article-title":"Frequency of protein Z deficiency in patients with ischaemic stroke","volume":"357","author":"Vasse","year":"2001","journal-title":"The Lancet"},{"key":"2025081709412584000_3.4.231.13","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1161\/01.STR.24.2.224","article-title":"Free protein S deficiency in acute ischemic stroke. 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