Novel hemostatic factor levels and risk of ischemic stroke: the Atherosclerosis Risk in Communities (ARIC) Study.

Abstract

BACKGROUND AND OBJECTIVE:

The role of hemostatic factor levels in cerebral infarction remains uncertain. We studied the association of levels of several under-studied hemostatic factors with ischemic stroke in a population-based cohort.

METHODS:

The Atherosclerosis Risk in Communities (ARIC) study includes 15,792 individuals aged 45-54 years at intake. Hemostatic factors II, V, IX, X, XI, XII, plasminogen and alpha(2)-antiplasmin were measured on frozen citrate plasma samples from 1990 to 1992. A case-cohort design was used, including all incident ischemic strokes (n = 89) over a median of 7.5 years and a stratified cohort random sample (n = 412). To determine the association of hemostatic factors with incident ischemic stroke, we computed hazard ratios (HRs) using multivariate proportional hazard regression analyses adjusted for demographic and other cardiovascular risk factors.

RESULTS:

The cohort random sample had a mean age (SD) of 56.9 (5.4) years and 42% were men. The age-, sex- and race-adjusted HRs for highest versus lowest quartiles were: factor XI (2.74, 95% CI 1.42-5.29), factor IX (1.92, 95% CI 0.99-3.73), and alpha(2)-antiplasmin (2.24, 95% CI 1.16-4.33). Correspondingly, the HRs of ischemic stroke per SD increment of factors XI, IX, and alpha(2)-antiplasmin were 1.64, 1.46 and 1.52, respectively (all p < 0.05). After multivariate adjustment including other clinical variables, the standardized HR remained significant for factor XI (1.50, 95% CI 1.10-2.05), but no other factor.

CONCLUSION:

A greater level of factor XI was associated with an increased risk of ischemic stroke. Higher factor XI levels might help identify patients at elevated ischemic stroke risk.

• Authors: M Fareed K Suri, Kazumasa Yamagishi, Nena Aleksic, Peter J Hannan, Aaron R Folsom
• Journal: Cerebrovascular diseases (Basel, Switzerland) (Cerebrovasc Dis) Vol. 29 Issue 5 Pg. 497-502 ( 2010) ISSN: 1421-9786 [Electronic] Switzerland
• PMID: 20299790 (Publication Type: Journal Article, Multicenter Study, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: Copyright 2010 S. Karger AG, Basel.

Chemical References

• Antifibrinolytic Agents
• Biomarkers
• Blood Coagulation Factors
• Plasminogen
• Factor XI

Topics

• Antifibrinolytic Agents (metabolism)
• Atherosclerosis (blood)
• Biomarkers (blood)
• Blood Coagulation Factors (metabolism)
• Case-Control Studies
• Cohort Studies
• Factor XI (metabolism)
• Female
• Hemostasis
• Humans
• Male
• Middle Aged
• Plasminogen (metabolism)
• Prospective Studies
• Regression Analysis
• Retrospective Studies
• Risk Factors
• Stroke (blood, epidemiology)