Plasma Pro-Enkephalin A and Ischemic Stroke Risk: The Reasons for Geographic and Racial Differences in Stroke Cohort

2022 ◽  
Vol 31 (2) ◽  
pp. 106237
Author(s):  
Samuel AP Short ◽  
Katherine Wilkinson ◽  
D Leann Long ◽  
Suzanne Judd ◽  
Janin Schulte ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Racial Differences ◽  
Stroke Risk ◽  
Ischemic Stroke Risk

Abstract P418: Increased Pro-neurotensin/neuromedin N is Associated With Incident Ischemic Stroke

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Charles D Nicoli ◽  
Nicholas Wettersten ◽  
George Howard ◽  
Virginia J Howard ◽  
Suzanne E Judd ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Racial Differences ◽  
Hemorrhagic Stroke ◽  
Stroke Risk ◽  
Disease Risk ◽  
Stroke Risk Factors ◽  
Increased Risk ◽  
Ischemic Stroke Risk ◽  
Neuromedin N

Introduction: The neuropeptide neurotensin (NT) has been linked to cardiovascular and metabolic disease risk. Through measurement of its stable equimolar precursor, pro-neurotensin/neuromedin N (pro-NT/NMN), hyperactivity of NT has been associated with aggregate cardiovascular outcomes that include stroke. However, the exclusive association of pro-NT/NMN with incident ischemic or hemorrhagic stroke has not been studied. Hypothesis: Higher serum pro-NT/NMN is associated with incident ischemic and hemorrhagic stroke. Methods: Prospective case-cohort study in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study. From 2003-2007, REGARDS enrolled 30,239 White or Black adults aged ≥45. Pro-NT/NMN was measured by immunoassay in 464 ischemic stroke cases, 49 hemorrhagic stroke cases, and 800 non-cases from a random cohort. Cox proportional-hazards models were used to calculate hazard ratios (HR) of stroke by pro-NT/NMN quartiles and per standard deviation (SD) of log pro-NT/NMN. Model 1 (both stroke types) included demographic factors as covariates, Model 2A (ischemic only) added ischemic stroke risk factors, and Model 2B (hemorrhagic only) added hemorrhagic stroke risk factors. Results: The table shows an increased HR of ischemic stroke for those in the 4th vs 1st-quartile pro-NT/NMN in Model 1 with a trend of increased risk across quartiles; this was attenuated in Model 2A. Prebaseline diabetes and coronary artery disease were the largest confounders of ischemic stroke risk, with each accounting for 19% of the association observed in Model 1. There was no association of pro-NT/NMN with hemorrhagic stroke in either model. There were no interactions of race or sex with log pro-NT/NMN. Conclusions: Higher pro-NT/NMN is associated with increased risk of ischemic stroke after adjusting for demographics, but this was not independent of stroke risk factors. No significant association with hemorrhagic stroke was observed; this analysis was limited by a small number of events.

scholarly journals Inflammatory cytokines and ischemic stroke risk

Neurology ◽  
2019 ◽  
Vol 92 (20) ◽  
pp. e2375-e2384 ◽  
Author(s):  
Nancy Swords Jenny ◽  
Peter W. Callas ◽  
Suzanne E. Judd ◽  
Leslie A. McClure ◽  
Brett Kissela ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Racial Differences ◽  
Racial Disparity ◽  
Stroke Risk ◽  
Black Population ◽  
Sample Mean ◽  
Stroke Incidence ◽  
Stroke Risk Factors ◽  
Ischemic Stroke Risk

ObjectiveWe studied circulating interleukin (IL)–6, IL-8, and IL-10 concentrations and incident ischemic stroke risk in a biracial cohort, and determined if these cytokines mediated the racial disparity in stroke incidence affecting the black population.MethodsThe Reasons for Geographic and Racial Differences in Stroke study enrolled 30,237 black and white men and women age ≥45 in 2003-2007. We measured baseline IL-6, IL-8, and IL-10 in a case–cohort study of 557 participants with incident stroke over 5.4 years and 951 participants in a cohort sample.ResultsIL-6, but not IL-8 or IL-10, was higher in cases compared to the cohort sample (mean 4.5 vs 3.7 ng/mL; p < 0.001). Only IL-6 was associated with stroke risk factors. Adjusting for age, sex, and race, the hazard ratio (HR; 95% confidence interval) for incident stroke for the highest vs lowest quartile of IL-6 was 2.4 (1.6–3.4). HRs for the highest vs lowest quartiles of IL-8 and IL-10 were 1.5 (1.0–2.1) and 1.4 (1.0–1.9), respectively. After additional adjustment for stroke risk factors, only higher IL-6 remained associated with stroke risk (HR 2.0; 1.2–3.1). Associations did not differ by race. Mediation analyses showed that IL-6 mediated the black–white disparity in stroke risk, but mediation was via IL-6 associations with stroke risk factors.ConclusionsIn this biracial population-based sample, IL-6 was strongly associated with risk of incident stroke and mediated the racial disparity in stroke via inflammatory effects of risk factors. Further study on the clinical utility of IL-6 measurement in stroke risk assessment would be helpful.

Abstract P389: Smoking, Biomarkers and Ischemic Stroke Risk: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Cohort

Circulation ◽  
2019 ◽  
Vol 139 (Suppl_1) ◽  
Author(s):  
Juan Conde ◽  
Maxwell Pistilli ◽  
Timothy Plante ◽  
Neil Zakai ◽  
Leslie McClure ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Racial Differences ◽  
Stroke Risk ◽  
Ischemic Stroke Risk

CYP2B6 Polymorphisms Are Associated with Ischemic Stroke Risk in a Chinese Han Population

2020 ◽  
Vol 70 (7) ◽  
pp. 1130-1139
Author(s):  
Guolong Tu ◽  
Wenliang Zhan ◽  
Yao Sun ◽  
Jiamin Wu ◽  
Zichao Xiong ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Stroke Risk ◽  
Chinese Han Population ◽  
Chinese Han ◽  
Han Population ◽  
Ischemic Stroke Risk

scholarly journals Using Ultrasound and Inflammation to Improve Prediction of Ischemic Stroke: A Secondary Analysis of the Multi-Ethnic Study of Atherosclerosis

2021 ◽  
pp. 37-43
Author(s):  
Hediyeh Baradaran ◽  
Alen Delic ◽  
Ka-Ho Wong ◽  
Nazanin Sheibani ◽  
Matthew Alexander ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Goodness Of Fit ◽  
Primary Outcome ◽  
Stroke Risk ◽  
Secondary Analysis ◽  
Predictor Variables ◽  
Baseline Model ◽  
Fit Statistics ◽  
Ischemic Stroke Risk

Introduction: Current ischemic stroke risk prediction is primarily based on clinical factors, rather than imaging or laboratory markers. We examined the relationship between baseline ultrasound and inflammation measurements and subsequent primary ischemic stroke risk. Methods: In this secondary analysis of the Multi-Ethnic Study of Atherosclerosis (MESA), the primary outcome is the incident ischemic stroke during follow-up. The predictor variables are 9 carotid ultrasound-derived measurements and 6 serum inflammation measurements from the baseline study visit. We fit Cox regression models to the outcome of ischemic stroke. The baseline model included patient age, hypertension, diabetes, total cholesterol, smoking, and systolic blood pressure. Goodness-of-fit statistics were assessed to compare the baseline model to a model with ultrasound and inflammation predictor variables that remained significant when added to the baseline model. Results: We included 5,918 participants. The primary outcome of ischemic stroke was seen in 105 patients with a mean follow-up time of 7.7 years. In the Cox models, we found that carotid distensibility (CD), carotid stenosis (CS), and serum interleukin-6 (IL-6) were associated with incident stroke. Adding tertiles of CD, IL-6, and categories of CS to a baseline model that included traditional clinical vascular risk factors resulted in a better model fit than traditional risk factors alone as indicated by goodness-of-fit statistics. Conclusions: In a multiethnic cohort of patients without cerebrovascular disease at baseline, we found that CD, CS, and IL-6 helped predict the occurrence of primary ischemic stroke. Future research could evaluate if these basic ultrasound and serum measurements have implications for primary prevention efforts or clinical trial inclusion criteria.

Impact of the PDE4D gene polymorphism and additional SNP–SNP and gene–smoking interaction on ischemic stroke risk in Chinese Han population

2017 ◽  
Vol 39 (4) ◽  
pp. 351-356 ◽  
Author(s):  
Xianxiang Wang ◽  
Zhongwu Sun ◽  
Yiquan Zhang ◽  
Xuefeng Tian ◽  
Qingxin Li ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Gene Polymorphism ◽  
Stroke Risk ◽  
Chinese Han Population ◽  
Chinese Han ◽  
Han Population ◽  
Ischemic Stroke Risk ◽  
Smoking Interaction

Abstract T P153: Women and Men with Ischemic Stroke in SiGN Have Different Subtype Distributions and Risk Factors

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Kathryn M Rexrode ◽  
Braxton D Mitchell ◽  
Kathleen A Ryan ◽  
Steven J Kittner ◽  
Hakan Ay ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Stroke Risk ◽  
Cardioembolic Stroke ◽  
Relative Distribution ◽  
Large Artery ◽  
Stroke Risk Factors ◽  
Stroke Subtypes ◽  
Small Artery Occlusion ◽  
Ischemic Stroke Risk

Introduction: The relative distribution of stroke risk factors, as well as ischemic stroke subtypes, in women compared with men is not well described. Hypothesis: We hypothesized that the distribution of ischemic stroke risk factors and subtypes would differ by sex, with a later onset in women and greater proportion of comorbidities. Methods: The NINDS Stroke Genetics Network (SiGN) consortium was established to evaluate genetic risk factors for ischemic stroke. A total of 23 separate studies performed Causative Classification of Stroke (CCS) typing using standardized criteria on ischemic stroke cases and contributed data on risk factors. We compared the distribution of ischemic stroke risk factors and CCS phenotypes between men and women with ischemic stroke. Results: Of the 16,228 ischemic strokes in SiGN, 8005 (49.3%) occurred in women. Median age at stroke was older in female than male stroke cases (73 vs. 66 years) (p=<0.0001). Among stroke cases, women were more likely than men cases to have hypertension or atrial fibrillation and less likely to have diabetes or coronary artery disease, or to smoke (p <0.003 for all). The distribution of stroke subtypes also differed by sex, with women less likely than men to have large artery infarction and small artery occlusion, and more likely to have cardioembolic stroke and undetermined stroke due to incomplete work-up (p values all <0.0001; see Table). Results were similar when the distribution of stroke subtypes was examined for those <70 years and ≥70 years, except for cardioembolic stroke remaining more common only among women ≥70. Conclusions: In this large group of carefully phenotyped ischemic strokes, the distribution of ischemic stroke subtypes and risk factor profiles differ significantly by sex. Evaluation of the causes of these differences may highlight areas for improved prevention and risk reduction in both genders.

Refinement of Ischemic Stroke Risk in Patients with Atrial Fibrillation and CHA2DS2-VASc Score of 1

2014 ◽  
Vol 37 (11) ◽  
pp. 1442-1447 ◽  
Author(s):  
DUO HUANG ◽  
LUO ANGUO ◽  
WEN-SHENG YUE ◽  
LIXUE YIN ◽  
HUNG-FAT TSE ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Stroke Risk ◽  
Ischemic Stroke Risk

Correlations of ANP Genetic Polymorphisms and Serum Levels with Ischemic Stroke Risk: A Meta-Analysis

2014 ◽  
Vol 18 (5) ◽  
pp. 349-356 ◽  
Author(s):  
De-Guang Xing ◽  
Dong-Yong Zhang ◽  
Zhan-Fu Wang ◽  
Da-Ling Ding ◽  
Jun Wang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Genetic Polymorphisms ◽  
Stroke Risk ◽  
Meta Analysis ◽  
Serum Levels ◽  
Ischemic Stroke Risk
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