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Associations of inflammatory and hemostatic variables with the risk of recurrent stroke.

Abstract：

BACKGROUND AND PURPOSE:Several prospective studies have shown significant associations between plasma fibrinogen, viscosity, C-reactive protein (CRP), fibrin D-dimer, or tissue plasminogen activator (tPA) antigen and the risk of primary cardiovascular events. Little has been published on the associations of these variables with recurrent stroke. We studied such associations in a nested case-control study derived from the Perindopril Protection Against Recurrent Stroke Study (PROGRESS). METHODS:Nested case-control study of ischemic (n=472) and hemorrhagic (n=83) strokes occurring during a randomized, placebo-controlled multicenter trial of perindopril-based therapy in 6105 patients with a history of stroke or transient ischemic attack. Controls were matched for age, treatment group, sex, region, and most recent qualifying event at entry to the parent trial. RESULTS:Fibrinogen and CRP were associated with an increased risk of recurrent ischemic stroke after accounting for the matching variables and adjusting for systolic blood pressure, smoking, peripheral vascular disease, and statin and antiplatelet therapy. The odds ratio for the last compared with the first third of fibrinogen was 1.34 (95% CI, 1.01 to 1.78) and for CRP was 1.39 (95% CI, 1.05 to 1.85). After additional adjustment for each other, these 2 odds ratios stayed virtually unchanged. Plasma viscosity, tPA, and d-dimer showed no relationship with recurrent ischemic stroke, although tPA was significant for lacunar and large artery subtypes. Although each of these variables showed a negative relationship with recurrent hemorrhagic stroke, none of these relationships achieved statistical significance. CONCLUSIONS:Fibrinogen and CRP are risk predictors for ischemic but not hemorrhagic stroke, independent of potential confounders.

journal_name

Stroke

journal_title

Stroke

authors

Woodward M,Lowe GD,Campbell DJ,Colman S,Rumley A,Chalmers J,Neal BC,Patel A,Jenkins AJ,Kemp BE,MacMahon SW

doi

10.1161/01.STR.0000181754.38408.4c

subject

Has Abstract

pub_date

2005-10-01 00:00:00

pages

2143-7

issue

eissn

0039-2499

issn

1524-4628

pii

01.STR.0000181754.38408.4c

journal_volume

pub_type

杂志文章,多中心研究,随机对照试验

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Associations of inflammatory and hemostatic variables with the risk of recurrent stroke.