Oral contraceptive use, thrombophilia and their interaction in young women with ischemic stroke

A. Bianchi Bonomi Hemophilia and Thrombosis Center, Department of Internal Medicine and Dermatology, University of Milan and IRCCS Maggiore Hospital, Mangiagalli and Regina Elena Foundation, Italy. martin@policlinico.mi.it

To investigate the role of oral contraceptives and their interaction with thrombophilia in ischemic stroke, a case-control study on women with a first ischemic stroke when younger than 45 years was carried out. Oral contraceptives doubled the risk of ischemic stroke in the first 6-18 months of use and hyperhomocysteinemia increased the risk by 3.5-fold. Carriers of factor V Leiden or prothrombin G20210A were not found to have a statistically significant increased risk. The risk of ischemic stroke in oral contraceptive users was 13 times higher in women who were also carriers of factor V Leiden and 9 times higher in those who also had hyperhomocysteinemia.

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