Elevated factor VIII level in cerebral venous thrombosis : a case-control study

Abstract

BACKGROUND: Cerebral venous thrombosis (CVT) is an uncommon disorder accounting for approximately 1% of strokes worldwide There is a paucity of data regarding the association between an elevated factor VIII level and cerebral venous thrombosis (CVT). METHODS: From June 2015 to January 2022, patients with confirmed CVT on neuroimaging were identified at two public hospitals in South Africa. Their clinical presentation, radiological characteristics of thrombosis, and risk factors for CVT were analysed. Age-, sex-, and HIV status-matched controls were recruited. Factor VIII levels were analysed in patients with CVT and in controls. RESULTS: The study included 26 patients with CVT and 52 controls. The mean age was 40.3 and 41.4 years for the patients and controls, respectively. In the study group, 73% were females. An elevated factor VIII level (>150 IU/dL) was the most common risk factor, identified in 61.5% (16/26) of patients with CVT. The mean factor VIII level was significantly higher in patients with CVT compared to controls (200.1 vs 156.9, p = 0.017). An elevated factor VIII level (>200 IU/dL) increased the risk of CVT four-fold (age- and sex-adjusted OR: 4.437, 95% CI: 1.435–13.723, p = 0.009). CONCLUSION: An elevated factor VIII level is a common risk factor for CVT; hence, investigation thereof should be included in the aetiological work-up. This study suggests that a higher cut-off value for factor VIII level increases the strength of the association with CVT.