Plasma factor VII-activating protease antigen levels and activity are increased in ischemic stroke

J Thromb Haemost. 2012 May;10(5):848-56. doi: 10.1111/j.1538-7836.2012.04692.x.


Background: Factor VII-activating protease (FSAP) is a recently discovered plasma protease with a role in the regulation of hemostasis and vascular remodeling processes. Higher levels and activity of FSAP have been reported in patients with deep vein thrombosis, but there are no data on plasma FSAP in ischemic stroke (IS).

Objective: To investigate whether FSAP antigen levels and activity are associated with IS and/or etiologic subtypes of IS.

Patients and methods: To assess the potential association between FSAP and IS, plasma FSAP antigen levels and activity were measured in 600 consecutive IS patients and 600 population-based controls from the case-control study the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS). Blood sampling was performed in the acute phase and 3 months after the index stroke. FSAP was also investigated at the genetic level by genotyping of 33 single-nucleotide polymorphisms.

Results: Increased FSAP antigen level and activity, at both time-points, were independently associated with IS. Subtype analysis revealed similar associations for both FSAP measures, at both time-points, in all main IS subtypes. FSAP genotypes showed association with both FSAP plasma measurements, but not with IS.

Conclusions: Increased plasma FSAP antigen levels and activity were associated with IS and all main etiologic subtypes, suggesting a possible role for FSAP in the pathophysiology of IS, irrespective of the underlying etiology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biomarkers / blood
  • Brain Ischemia / blood
  • Brain Ischemia / enzymology*
  • Brain Ischemia / epidemiology
  • Brain Ischemia / genetics
  • Case-Control Studies
  • Female
  • Genotype
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Phenotype
  • Polymorphism, Single Nucleotide
  • Risk Assessment
  • Risk Factors
  • Serine Endopeptidases / blood*
  • Serine Endopeptidases / genetics
  • Stroke / blood
  • Stroke / enzymology*
  • Stroke / epidemiology
  • Stroke / genetics
  • Sweden / epidemiology
  • Up-Regulation


  • Biomarkers
  • HABP2 protein, human
  • Serine Endopeptidases