Sex Differences in Hemostatic Factors in Patients With Ischemic Stroke and the Relation With Migraine—A Systematic Review

Background: Women are more affected by stroke than men. This might, in part, be explained by sex differences in stroke pathophysiology. The hemostasis system is influenced by sex hormones and associated with female risk factors for stroke, such as migraine.Aim: To systematically review possible sex...

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Autores principales:	Nelleke van der Weerd, Hine J. A. van Os, Mariam Ali, Jan W. Schoones, Arn M. J. M. van den Maagdenberg, Nyika D. Kruyt, Bob Siegerink, Marieke J. H. Wermer
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	male female risk factor migraine coagulation plasma Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
Acceso en línea:	https://doaj.org/article/e6ae621f8b5f40d6b709e4f3772d3e48
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spelling	oai:doaj.org-article:e6ae621f8b5f40d6b709e4f3772d3e482021-11-11T09:38:39ZSex Differences in Hemostatic Factors in Patients With Ischemic Stroke and the Relation With Migraine—A Systematic Review1662-510210.3389/fncel.2021.711604https://doaj.org/article/e6ae621f8b5f40d6b709e4f3772d3e482021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fncel.2021.711604/fullhttps://doaj.org/toc/1662-5102Background: Women are more affected by stroke than men. This might, in part, be explained by sex differences in stroke pathophysiology. The hemostasis system is influenced by sex hormones and associated with female risk factors for stroke, such as migraine.Aim: To systematically review possible sex differences in hemostatic related factors in patients with ischemic stroke in general, and the influence of migraine on these factors in women with ischemic stroke.Results: We included 24 studies with data on sex differences of hemostatic factors in 7247 patients with ischemic stroke (mean age 57–72 years, 27–57% women) and 25 hemostatic related factors. Levels of several factors were higher in women compared with men; FVII:C (116% ± 30% vs. 104% ± 30%), FXI (0.14 UI/mL higher in women), PAI-1 (125.35 ± 49.37 vs. 96.67 ± 38.90 ng/mL), D-dimer (1.25 ± 0.31 vs. 0.95 ± 0.24 μg/mL), and aPS (18.7% vs. 12.0% positive). In contrast, protein-S (86.2% ± 23.0% vs. 104.7% ± 19.8% antigen) and P-selectin (48.9 ± 14.4 vs. 79.1 ± 66.7 pg/mL) were higher in men. Most factors were investigated in single studies, at different time points after stroke, and in different stroke subtypes. Only one small study reported data on migraine and hemostatic factors in women with ischemic stroke. No differences in fibrinogen, D-dimer, t-PA, and PAI-1 levels were found between women with and without migraine.Conclusion: Our systematic review suggests that sex differences exist in the activation of the hemostatic system in ischemic stroke. Women seem to lean more toward increased levels of procoagulant factors whereas men exhibit increased levels of coagulation inhibitors. To obtain better insight in sex-related differences in hemostatic factors, additional studies are needed to confirm these findings with special attention for different stroke phases, stroke subtypes, and not in the least women specific risk factors, such as migraine.Nelleke van der WeerdNelleke van der WeerdHine J. A. van OsMariam AliJan W. SchoonesArn M. J. M. van den MaagdenbergArn M. J. M. van den MaagdenbergNyika D. KruytNyika D. KruytBob SiegerinkMarieke J. H. WermerMarieke J. H. WermerFrontiers Media S.A.articlemalefemalerisk factormigrainecoagulationplasmaNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571ENFrontiers in Cellular Neuroscience, Vol 15 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	male female risk factor migraine coagulation plasma Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
spellingShingle	male female risk factor migraine coagulation plasma Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Nelleke van der Weerd Nelleke van der Weerd Hine J. A. van Os Mariam Ali Jan W. Schoones Arn M. J. M. van den Maagdenberg Arn M. J. M. van den Maagdenberg Nyika D. Kruyt Nyika D. Kruyt Bob Siegerink Marieke J. H. Wermer Marieke J. H. Wermer Sex Differences in Hemostatic Factors in Patients With Ischemic Stroke and the Relation With Migraine—A Systematic Review
description	Background: Women are more affected by stroke than men. This might, in part, be explained by sex differences in stroke pathophysiology. The hemostasis system is influenced by sex hormones and associated with female risk factors for stroke, such as migraine.Aim: To systematically review possible sex differences in hemostatic related factors in patients with ischemic stroke in general, and the influence of migraine on these factors in women with ischemic stroke.Results: We included 24 studies with data on sex differences of hemostatic factors in 7247 patients with ischemic stroke (mean age 57–72 years, 27–57% women) and 25 hemostatic related factors. Levels of several factors were higher in women compared with men; FVII:C (116% ± 30% vs. 104% ± 30%), FXI (0.14 UI/mL higher in women), PAI-1 (125.35 ± 49.37 vs. 96.67 ± 38.90 ng/mL), D-dimer (1.25 ± 0.31 vs. 0.95 ± 0.24 μg/mL), and aPS (18.7% vs. 12.0% positive). In contrast, protein-S (86.2% ± 23.0% vs. 104.7% ± 19.8% antigen) and P-selectin (48.9 ± 14.4 vs. 79.1 ± 66.7 pg/mL) were higher in men. Most factors were investigated in single studies, at different time points after stroke, and in different stroke subtypes. Only one small study reported data on migraine and hemostatic factors in women with ischemic stroke. No differences in fibrinogen, D-dimer, t-PA, and PAI-1 levels were found between women with and without migraine.Conclusion: Our systematic review suggests that sex differences exist in the activation of the hemostatic system in ischemic stroke. Women seem to lean more toward increased levels of procoagulant factors whereas men exhibit increased levels of coagulation inhibitors. To obtain better insight in sex-related differences in hemostatic factors, additional studies are needed to confirm these findings with special attention for different stroke phases, stroke subtypes, and not in the least women specific risk factors, such as migraine.
format	article
author	Nelleke van der Weerd Nelleke van der Weerd Hine J. A. van Os Mariam Ali Jan W. Schoones Arn M. J. M. van den Maagdenberg Arn M. J. M. van den Maagdenberg Nyika D. Kruyt Nyika D. Kruyt Bob Siegerink Marieke J. H. Wermer Marieke J. H. Wermer
author_facet	Nelleke van der Weerd Nelleke van der Weerd Hine J. A. van Os Mariam Ali Jan W. Schoones Arn M. J. M. van den Maagdenberg Arn M. J. M. van den Maagdenberg Nyika D. Kruyt Nyika D. Kruyt Bob Siegerink Marieke J. H. Wermer Marieke J. H. Wermer
author_sort	Nelleke van der Weerd
title	Sex Differences in Hemostatic Factors in Patients With Ischemic Stroke and the Relation With Migraine—A Systematic Review
title_short	Sex Differences in Hemostatic Factors in Patients With Ischemic Stroke and the Relation With Migraine—A Systematic Review
title_full	Sex Differences in Hemostatic Factors in Patients With Ischemic Stroke and the Relation With Migraine—A Systematic Review
title_fullStr	Sex Differences in Hemostatic Factors in Patients With Ischemic Stroke and the Relation With Migraine—A Systematic Review
title_full_unstemmed	Sex Differences in Hemostatic Factors in Patients With Ischemic Stroke and the Relation With Migraine—A Systematic Review
title_sort	sex differences in hemostatic factors in patients with ischemic stroke and the relation with migraine—a systematic review
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/e6ae621f8b5f40d6b709e4f3772d3e48
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Sex Differences in Hemostatic Factors in Patients With Ischemic Stroke and the Relation With Migraine—A Systematic Review

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