People with defective pulmonary capillary filtration are at higher risk of having an ischemic stroke if they have low iron levels, possibly due to enhanced platelet aggregation, according to a study published in PLOS ONE.

Claire L. Shovlin, Ph.D., 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 researchers found that 12.3 percent of patients had an acute, non-iatrogenic ischemic stroke at a median of 52 years of age. Low serum iron was associated with a greater risk of stroke, with approximately double the risk at 6 µmol/L compared to the mid-normal range of 7 to 27 µmol/L. Platelets from patients with low iron levels more easily aggregated in response to serotonin, which was reversed after iron treatment.

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“These data suggest that patients with compromised pulmonary capillary filtration due to pulmonary arteriovenous malformations are at increased risk of ischemic stroke if they are iron deficient, and that mechanisms are likely to include enhanced aggregation of circulating platelets,” Shovlin and colleagues conclude.