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HIND - Hypercoagulability in Neurovascular Disorders

This research project transforms laboratory knowledge into epidemiological research questions in order to investigate the clinical relevance of the role of hypercoagulability in neurovascular diseases.
More information/project description

Research Group Siegerink

Project Description

Background

  • Coagulation factors of the intrinsic coagulation pathway, which is initiated when blood contacts negatively charged surfaces, contribute to increased clotting propensity (hypercoagulability), but their role in ischemic stroke has not yet been explored in detail.
  • Recently, an association between elevated levels of coagulation factor XI (of the intrinsic pathway) and an increase in ischemic stroke risk in young women has been demonstrated. Furthermore, promising new research has emerged targeting intrinsic coagulation pathway factors in the context of anticoagulation therapy.
  • A dose-dependent association has been observed between elevated levels of coagulation factor VIII (hypercoagulability) and thrombosis. Elevated levels of factor VIII indicate increased clotting activity, which may lead to small clots in the brain and small regions of tissue death, visible on MRI scans as white matter lesions. Research has linked white matter lesions to diminished cognitive function.

Aims and Objectives

At this point, it remains unclear whether hypercoagulability…

  • affects ischemic stroke recurrence
  • has a differential effect on the risk for different subtypes of stroke
  • plays a role in the development of white matter lesions and subsequent cognitive impairment

Therefore, our scientific aim is to elucidate the role of hypercoagulability in the etiological mechanisms of neurovascular disorders in three subprojects to address these three points.

Methods

  • Our research involves cross-sectional analysis of prospective data from multiple ongoing studies including our own PROSCIS-B at the CSB and two large international studies.
  • We will measure the activities and antigen levels of biomarkers of hypercoagulability and determine whether elevated levels are associated with recurrent stroke or a specific subtype of ischemic stroke (as categorized by the TOAST classification system).
  • We will determine whether elevated levels of coagulation factors are associated with more frequent and/or more severe white matter lesions and whether these levels can also be linked to cognitive impairment.

Coordination

Jessica Rohmann, MScPH, PhD Candidate
Bob Siegerink, PhD

Status

Project research began in June 2015

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