Plasma Fibrinogen Concentrations and Risk of Stroke and Its Subtypes Among Japanese Men and Women

Sato, Shinichi; Iso, Hiroyasu; Noda, Hiroyuki; Kitamura, Akihiko; Imano, Hironori; Kiyama, Masahiko; Ohira, Tetsuya; Okada, Takeo; Yao, Masayuki; Tanigawa, Takeshi; Yamagishi, Kazumasa; Nakamura, Masakazu; Naito, Yoshihiko; Satō, Takashi

doi:10.1161/01.str.0000242473.13884.8e

Cited by 24 publications

(19 citation statements)

References 37 publications

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“…29 -33 Only recently has fibrinogen been associated with hemorrhagic stroke. 29,34,35 Consistent with our results, all of these studies 29,34,35 reported greater fibrinogen was associated with a higher risk of ICH. It seems somewhat paradoxical that elevated fibrinogen, if prothrombotic, would be associated with greater risk of hemorrhagic stroke.…”

Section: Discussionsupporting

confidence: 90%

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

Sturgeon

Folsom

Longstreth

et al. 2008

Stroke

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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.

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Section: Discussionsupporting

confidence: 90%

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

Sturgeon

Folsom

Longstreth

et al. 2008

Stroke

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“…The recent prospective Japanese study made the surprising observation that fibrinogen level was associated with hemorrhagic stroke, especially intraparenchymal hemorrhage, 2 but had a nonsignificant negative association with IS. 2 These findings 2 differ not only from those of Western studies, [3][4][5] but also from the present study.…”

Section: Discussioncontrasting

confidence: 90%

Fibrinogen Independently Predicts the Development of Ischemic Stroke in a Taiwanese Population

Chuang

Bai

Chen

et al. 2009

Stroke

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Background and Purpose-Of few prospective studies that have focused on the relationship between fibrinogen and ischemic stroke (IS) in Asian populations, the findings were inconsistent with those conducted in Western countries. Therefore, we aimed to investigate the temporal relationship between fibrinogen levels (plus several related parameters) and IS in a community-based study in Taiwan. Methods-Baseline data from 3281 adults (Ն20 years of age) in the Cardiovascular Diseases Risk Factor Two-Township Study were linked to incidental IS status derived from insurance claims and death certificate records. Hazard ratios and 95% CIs of clotting factors (fibrinogen, factor VII, factor VIII, and antithrombin-III) for IS events were estimated using Cox proportional hazard models. Results-With 10.4 years (average) follow-up, 128 persons developed IS (3.75 per 1000 person-years). As expected, elevated blood pressure and diabetes were independent predictors of IS events. A dose-response relationship was found in univariate analysis between IS risk and tertiles of fibrinogen (hazard ratio, 3.73; 2.19 to 1.00), factor VII (hazard ratio, 1.86; 1.35 to 1.00), and factor VIII (2.97; 1.70 to 1.00), respectively, but not for antithrombin-III. After adjusting for confounding and known risk factors, fibrinogen independently predicted IS events. A 72% increase (hazard ratio,

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“…It is unclear why the association of hs-CRP with the risk of ischemic stroke risk was weaker than that with the risk of myocardial infarction. Previous studies showed a difference in the pathology and its risk factors between ischemic stroke and ischemic heart disease [36][37][38][39][40] . For example, myocardial infarction is mostly due to atherosclerosis of coronary arteries, which is characterized by strong inflammation processes with the proliferation of endothelial cells and smooth muscle cells along with the migration and differentiation of monocytes and macrophages 41) , whereas ischemic stroke is due to the atherosclerosis of large cerebral arteries and/or cortical arteries (thrombo-embolic infarction) or arteriosclerosis of small intracerebral arteries (lacunar infarction), the latter of which may have weaker inflammation processes.…”

Section: Acknowledgementsmentioning

confidence: 99%

The Impact of C-Reactive Protein on Risk of Stroke, Stroke Subtypes, and Ischemic Heart Disease in Middle-Aged Japanese: the Japan Public Health Center-Based Study

Iso

Noda

Ikeda

et al. 2012

JAT

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Aim:To examine the impact of C-reactive protein on the risks of stroke and its subtypes, particularly among Asian populations in which median C-reactive protein levels are typically lower than in Western populations. Methods: A prospective, nested case-control study was conducted to examine the associations between high sensitivity-CRP (hs-CRP) and risks of cardiovascular disease within a cohort of 29,876 men and women aged 40-69 years, with no history of stroke, ischemic heart disease or cancer, who submitted blood samples between 1990 and 1993. Systematic cardiovascular surveillance was performed throughout 2007. One control for each stroke and two controls for each ischemic heart disease were matched for sex, age, date of blood drawing, time since last meal and study location. Results: We documented 1,132 incident strokes (638 ischemic and 494 hemorrhagic strokes) and 209 ischemic heart diseases (168 myocardial infarctions and 41 sudden cardiac deaths), and observed a linear association between hs-CRP levels and risks of ischemic stroke and ischemic heart disease, more specifically myocardial infarction. The multivariable odds ratios associated with 1-SD increment of logarithmically transformed hs-CRP were 1.13 (0.99-1.29), p=0.07 for ischemic stroke, 1.16 (0.96-1.41), p=0.13 for lacunar infarction, 1.41 (0.98-2.01), p=0.06 for embolic infarction, and 1.28 (1.03-1.59), p= 0.03 for myocardial infarction. The predictive value of hs-CRP for ischemic stroke was reduced primarily after adjustment for hypertensive status and body mass index. No association was found between hs-CRP levels and the risk of hemorrhagic or total stroke. Conclusions: High serum hs-CRP levels were associated with the risk of myocardial infarction and more weakly with the risk of ischemic stroke among middle-aged Japanese men and women.

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Plasma Fibrinogen Concentrations and Risk of Stroke and Its Subtypes Among Japanese Men and Women

Cited by 24 publications

References 37 publications

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

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

Fibrinogen Independently Predicts the Development of Ischemic Stroke in a Taiwanese Population

The Impact of C-Reactive Protein on Risk of Stroke, Stroke Subtypes, and Ischemic Heart Disease in Middle-Aged Japanese: the Japan Public Health Center-Based Study

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