Lipoprotein(a) and Risk of Ischemic Stroke in the REGARDS Study
| Autor: | Pankaj Arora, Rajat Kalra, Virginia G. Wadley, Peter W. Callas, Brett M. Kissela, Kristine S. Alexander, Suzanne E. Judd, Garima Arora, Mary Cushman, Neil A. Zakai |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Risk medicine.medical_specialty Black People 030204 cardiovascular system & hematology White People Article Brain Ischemia Cohort Studies 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Geography Medical Stroke Aged Proportional Hazards Models biology business.industry Proportional hazards model Incidence (epidemiology) Models Cardiovascular Lipoprotein(a) Middle Aged medicine.disease Lipids United States Coronary heart disease Ischemic stroke biology.protein Cardiology Female Cardiology and Cardiovascular Medicine business Stroke incidence 030217 neurology & neurosurgery Follow-Up Studies Program Evaluation Lipoprotein |
| Zdroj: | Arteriosclerosis, Thrombosis, and Vascular Biology. 39:810-818 |
| ISSN: | 1524-4636 1079-5642 |
| Popis: | Objective— Increased Lp(a) [lipoprotein(a)] is associated with coronary heart disease risk, but links with stroke are less consistent. Blacks have higher Lp(a) levels and stroke incidence than whites but have been underrepresented in studies. We hypothesized that Lp(a) is a risk factor for ischemic stroke and that risk differs by race. Approach and Results— REGARDS (Reasons for Geographic and Racial Differences in Stroke) recruited 30 239 black and white US adults aged ≥45 in 2003–2007 to study regional and racial differences in stroke mortality. We measured baseline Lp(a) by immunonephelometric assay in 572 cases of incident ischemic stroke and a 967-person cohort random sample. The hazard ratio of stroke by baseline Lp(a) was calculated using Cox proportional hazards models, stratified by race. Lp(a) was modeled in sex- and race-specific quartiles, given known differences in distributions by race and sex. Interactions were tested by including interaction terms in the proportional hazards models, with P P interaction=0.12. Lp(a) was lower in men than women, but associations with stroke in men and women were similar. Conclusions— We confirm that Lp(a) is a risk factor for ischemic stroke. Further research is needed to confirm the role of racial differences of the Lp(a) risk multiplier in ischemic stroke. |
| Databáze: | OpenAIRE |
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