Hemostatic and Inflammatory Risk Factors for Intracerebral Hemorrhage in a Pooled Cohort

Abstract

Background and Purpose-The purpose of this study was to identify novel risk factors for intracerebral hemorrhagic stroke (ICH). Methods-Risk factors were assessed at baseline in a pooled cohort of the Atherosclerosis Risk in Communities Study (ARIC) and the Cardiovascular Health Study (CHS) involving 21 680 adults aged 45 or over. Over 263 489 person-years of follow-up, we identified 135 incident ICH events. Results-In multivariable models, for each SD higher baseline level of fibrinogen, the relative rate of incident ICH increased 35% (95% CI, 17% to 55%). Fibrinogen was more strongly related to ICH in ARIC than in CHS. In multivariable models, those with von Willebrand factor levels above the median were 1.72 (95% CI, 0.97 to 3.03) times more likely to have an incident ICH as those below the median. Factor VIII was significantly positively related to ICH in ARIC (relative rate per standard deviation of 1.31; 95% CI, 1.07 to 1.62), but not in CHS. There was no relation in multivariable models between lipoprotein (a), Factor VII, white blood cell count, or C-reactive protein and ICH. Conclusions-Greater plasma fibrinogen and, to some degree, von Willebrand factor were associated with increased rates of ICH in these prospective studies, whereas Factor VIII was related to ICH in younger ARIC study participants only.

Age-Related Macular Degeneration and the Risk of Stroke

“…Inflammation and complement activation contribute to the development of secondary brain injury after intracerebral hemorrhage, 24 but there is no evidence for their contribution to the onset of intracerebral hemorrhage. 25 In the present study, the association between AMD and intracerebral hemorrhage remained unchanged after adjustment for C-reactive protein levels or CFH, suggesting that inflammation and complement activation are less likely to explain the association. Nevertheless, we cannot rule out the possibility of other inflammatory proteins or complement components being involved in a common pathway.…”

Comprehensive Overview of Nursing and Interdisciplinary Care of the Acute Ischemic Stroke Patient

“…1 Common causes and risk factors for ICH are hypertension (the number 1 cause), bleeding disorders, African-American ethnicity, aging, vascular malformations, excessive use/abuse of alcohol, and liver dysfunction. [17][18][19][20] The primary cause of SAH is a ruptured cerebral aneurysm.…”

Association Between Serum Phosphate Levels and Stroke Risk in Patients Undergoing Hemodialysis

“…Vascular inflammation has been shown to induce brain hemorrhage in both humans and animal models. 26,27 Phosphate loading directly induced inflammation in vascular smooth muscle cells and increased the expression of matrix metalloproteinases II and IX and cathepsin S, 28,29 which degrade extracellular matrix and disrupt the integrity of vascular layers. Furthermore, phosphate loading also induced the apoptosis of vascular smooth muscle cells and endothelial cells via oxidative stress and inflammation.…”