HealthDay News — Iron deficiency may raise ischemic stroke risk in patients with defective pulmonary capillary filtration, possibly due to enhanced platelet aggregation, study findings indicate.

Claire L. Shovlin, PhD, from Imperial College London, and colleagues, investigated factors associated with the risk of ischemic stroke in 497 patients with pulmonary arteriovenous malformations due to hereditary hemorrhagic telangiectasia.The findings were published in PLOS ONE.

Overall, 61 participants (12.3%) had an acute, non-iatrogenic ischemic stroke at a median age of 52 years.

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Stroke risk was associated not with venous thromboemboli or conventional neurovascular risk factors, in crude and age-adjusted logistic regression, but with low serum iron (adjusted odds ratio 0.96; 95% CI: 0.92-1.00) and more weakly with low oxygen saturations reflecting a larger right-to-left shunt (adjusted OR 0.96; 95% CI: 0.92- 1.01).

Low serum iron was associated with a greater risk for stroke, with approximately double the risk at 6 µmol/L compared to the mid-normal range of 7 to 27 µmol/L, the researchers found. Furthermore, platelets from patients with low iron levels more easily aggregated in response to serotonin, which was reversed after iron treatment.

“[T]he data indicate that iron deficiency and circulating platelets provide potentially novel opportunities for targeted stroke reduction strategies that could be examined in future clinical trials, particularly in the setting of compromised pulmonary capillary filtration,” Shovlin and colleagues concluded.


  1. Shovlin CL et al. PLOS ONE. 2014; doi: 10.1371/journal.pone.0088812.