{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T15:29:08Z","timestamp":1789140548166,"version":"build-2803163510"},"reference-count":25,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:00:00Z","timestamp":1773792000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Takayasu arteritis is an important non-atherosclerotic cause of ischemic stroke in young adults. However, the relative contribution of systemic inflammation, inherited thrombophilia, and supra-aortic hemodynamic impairment to cerebrovascular events in these patients remains insufficiently defined. This study aimed to evaluate the relative impact of systemic inflammatory activity, hereditary and acquired thrombophilia markers, and supra-aortic vascular involvement on cerebrovascular ischemic events in patients with digital subtraction angiography (DSA) confirmed supra-aortic Takayasu arteritis. Methods: A retrospective cross-sectional analysis was conducted in consecutively evaluated patients with non-atherosclerotic inflammatory stenosis or occlusion of the carotid, subclavian, or vertebral arteries confirmed by digital subtraction angiography. Age- and sex-matched hospital-based individuals without autoimmune, thrombotic, or cerebrovascular diseases served as controls. Laboratory assessments including erythrocyte sedimentation rate, lipoprotein(a), homocysteine, antinuclear antibody, rheumatoid factor, antiphospholipid antibodies, and a hereditary thrombophilia panel were obtained 4\u20136 weeks after clinical presentation during a stable clinical phase. Results: Among 46 patients with Takayasu arteritis, 21 patients presented with ischemic stroke. The stroke-positive subgroup demonstrated higher inflammatory activity and a slightly greater prevalence of supra-aortic occlusive lesions, particularly involving the common carotid, internal carotid, and subclavian arteries. Although lipoprotein(a) levels showed statistical differences between groups, mean values remained within reference ranges and were not clinically elevated. The distribution of hereditary thrombophilia variants and the prevalence of elevated homocysteine levels did not differ significantly between groups. Clinical outcomes were favorable overall, with no mortality and functional independence achieved in the majority of stroke-positive patients. Conclusions: These findings suggest that systemic inflammation and supra-aortic hemodynamic impairment may play a more prominent role than inherited thrombophilia in the development of cerebrovascular ischemic events in patients with Takayasu arteritis. Selective rather than routine thrombophilia testing may therefore be appropriate in selected clinical contexts, while careful control of inflammatory activity and continuous vascular monitoring remain essential components of management.<\/jats:p>","DOI":"10.3390\/jcm15062308","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T07:35:08Z","timestamp":1773819308000},"page":"2308","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Inflammation and Thrombophilia Markers in Supra-Aortic Takayasu Arteritis-Associated Stroke: A Digital Subtraction Angiography-Based Case Control Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5125-2855","authenticated-orcid":false,"given":"Ebru","family":"Marzioglu Ozdemir","sequence":"first","affiliation":[{"name":"Department of Medical Genetic, Selcuk University, Konya 42130, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8140-6333","authenticated-orcid":false,"given":"Gokhan","family":"Ozdemir","sequence":"additional","affiliation":[{"name":"Department of Neurology, Center of Stroke, Selcuk University Medical Faculty, Konya 42130, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1007\/s00296-018-4157-3","article-title":"Diagnosis and differential diagnosis of large-vessel vasculitides","volume":"39","author":"Keser","year":"2019","journal-title":"Rheumatol. Int."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1136\/svn-2020-000809","article-title":"Incidence, prevalence and risk of stroke in patients with Takayasu arteritis: A nationwide population-based study in South Korea","volume":"7","author":"Ahn","year":"2022","journal-title":"Stroke Vasc. Neurol."},{"key":"ref_3","first-page":"S33","article-title":"Epidemiology of Takayasu\u2019s arteritis in Turkey","volume":"34","author":"Birlik","year":"2016","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1007\/s00296-016-3445-z","article-title":"The epidemiology of Takayasu arteritis: A hospital-based study from northwestern part of Turkey","volume":"36","author":"Saritas","year":"2016","journal-title":"Rheumatol. Int."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3458","DOI":"10.1161\/STROKEAHA.121.034445","article-title":"Cerebrovascular ischemic events in patients with Takayasu arteritis","volume":"53","author":"Mirouse","year":"2022","journal-title":"Stroke"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"22","DOI":"10.2478\/rir-2023-0004","article-title":"Clinical and vascular features of stroke in Takayasu\u2019s arteritis: A 24-year retrospective study","volume":"4","author":"Zhang","year":"2023","journal-title":"Rheumatol. Immunol. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"109","DOI":"10.3988\/jcn.2012.8.2.109","article-title":"Ischemic stroke in Takayasu\u2019s arteritis: Lesion patterns and possible mechanisms","volume":"8","author":"Hwang","year":"2012","journal-title":"J. Clin. Neurol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1846","DOI":"10.3899\/jrheum.150097","article-title":"Clinical features and outcomes of Takayasu arteritis with neurological symptoms in China: A retrospective study","volume":"42","author":"Yang","year":"2015","journal-title":"J. Rheumatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1161\/CIRCULATIONAHA.120.046657","article-title":"Medium- and large-vessel vasculitis","volume":"143","author":"Saadoun","year":"2021","journal-title":"Circulation"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"448","DOI":"10.5543\/tkda.2021.69741","article-title":"Polymorphisms of F2 (G20210A), F5 (G1691A), F7 (G10976A), F13 (G13T), FGB, ITGA2, ITGB3, and PAI-1 genes and their association with thrombotic complications in patients suffering from Takayasu aortoarteritis of the Urals population","volume":"49","author":"Borodina","year":"2021","journal-title":"Turk Kardiyol. Dern. Ars."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s12959-015-0047-z","article-title":"Thrombosis in vasculitis: From pathogenesis to treatment","volume":"13","author":"Emmi","year":"2015","journal-title":"Thromb. J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e30615","DOI":"10.1016\/j.heliyon.2024.e30615","article-title":"Thrombosis in vasculitis: An updated review of etiology, pathophysiology, and treatment","volume":"10","author":"Zhu","year":"2024","journal-title":"Heliyon"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"67","DOI":"10.12659\/PJR.883633","article-title":"Imaging difficulties in Takayasu arteritis: Case report and review of the literature","volume":"77","author":"Bryl","year":"2012","journal-title":"Pol. J. Radiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1872","DOI":"10.1002\/art.42324","article-title":"2022 American College of Rheumatology\/EULAR classification criteria for Takayasu arteritis","volume":"74","author":"Grayson","year":"2022","journal-title":"Arthritis Rheumatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e012877","DOI":"10.1161\/JAHA.119.012877","article-title":"Inherited thrombophilia and the risk of arterial ischemic stroke: A systematic review and meta-analysis","volume":"8","author":"Chiasakul","year":"2019","journal-title":"J. Am. Heart Assoc."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Danda, D., Manikuppam, P., Tian, X., and Harigai, M. (2022). Advances in Takayasu arteritis: An Asia Pacific perspective. Front. Med., 9.","DOI":"10.3389\/fmed.2022.952972"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"919","DOI":"10.7326\/0003-4819-120-11-199406010-00004","article-title":"Takayasu arteritis","volume":"120","author":"Kerr","year":"1994","journal-title":"Ann. Intern. Med."},{"key":"ref_18","first-page":"e42667","article-title":"Pathophysiology, diagnosis, and management of Takayasu arteritis: A review of current advances","volume":"15","author":"Bhandari","year":"2023","journal-title":"Cureus"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1016\/j.jcmg.2012.01.013","article-title":"Role of FDG PET\u2013CT in Takayasu arteritis: Sensitive detection of recurrences","volume":"5","author":"Tezuka","year":"2012","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_20","first-page":"1795","article-title":"Disease assessment in Takayasu\u2019s arteritis","volume":"52","author":"Aydin","year":"2013","journal-title":"Rheumatology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1007\/BF02936534","article-title":"Takayasu\u2019s arteritis: A review of the literature","volume":"1","author":"Maffei","year":"2006","journal-title":"Intern. Emerg. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"268","DOI":"10.2478\/jtim-2020-0040","article-title":"Factor V Leiden mutation frequency and geographical distribution in Turkish population","volume":"8","author":"Yildiz","year":"2020","journal-title":"J. Transl. Int. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"303","DOI":"10.3899\/jrheum.121073","article-title":"Homocysteine levels in Takayasu arteritis: A risk factor for arterial ischemic events","volume":"40","author":"Oliveira","year":"2013","journal-title":"J. Rheumatol."},{"key":"ref_24","first-page":"S59","article-title":"Takayasu\u2019s arteritis in Turkey: Clinical and angiographic features of 248 patients","volume":"27","author":"Bicakcigil","year":"2009","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1007\/s00424-023-02805-z","article-title":"Tobacco smoking and vascular biology and function: Evidence from human studies","volume":"475","author":"Hahad","year":"2023","journal-title":"Pflug. Arch."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/6\/2308\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T07:58:14Z","timestamp":1773820694000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/6\/2308"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,18]]},"references-count":25,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["jcm15062308"],"URL":"https:\/\/doi.org\/10.3390\/jcm15062308","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,18]]}}}