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      β-Fibrinogen Gene -455 G/A Polymorphism in Korean Ischemic Stroke Patients

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          Abstract

          Background and Purpose

          We investigated the relationship between the β-fibrinogen gene (FGB) -455 G/A polymorphism and plasma fibrinogen levels in Korean ischemic stroke patients. We also determined whether the frequency of the -455 G/A polymorphism differed between two subtypes of noncardioembolic stroke: large-artery atherosclerosis (LAA) and small-vessel occlusion (SVO).

          Methods

          A total of 267 patients with noncardioembolic stroke were enrolled. Plasma fibrinogen and other risk factors for stroke were evaluated. FGB -455 G/A genotypes were determined by polymerase chain reaction with restrictive enzyme Hae III and automatic DNA sequencing.

          Results

          The FGB -455 G/A polymorphism was significantly associated with an elevated plasma fibrinogen level ( p<0.001). The frequency of the A allele in Korean stroke patients was 16.7%. However, the frequency of the -455 G/A polymorphism did not differ between LAA and SVO.

          Conclusions

          The plasma fibrinogen level might be affected by the -455 G/A polymorphism in noncardioembolic stroke patients. However, the LAA and SVO subtypes of ischemic stroke were not affected by the -455 G/A polymorphism.

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          Most cited references26

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          Association of fibrinogen, C-reactive protein, albumin, or leukocyte count with coronary heart disease: meta-analyses of prospective studies.

          J Danesh, R. Collins, P Appleby … (1998)
          A large number of epidemiologic studies have reported on associations between various "inflammatory" factors and coronary heart disease (CHD). To assess the associations of blood levels of fibrinogen, C-reactive protein (CRP), and albumin and leukocyte count with the subsequent risk of CHD. Meta-analyses of any long-term prospective studies of CHD published before 1998 on any of these 4 factors. Studies were identified by MEDLINE searches, scanning of relevant reference lists, hand searching of cardiology, epidemiology, and other relevant journals, and discussions with authors of relevant reports. All relevant studies identified were included. The following information was abstracted from published reports (supplemented, in several cases, by the authors): size and type of cohort, mean age, mean duration of follow-up, assay methods, degree of adjustment for confounders, and relationship of CHD risk to the baseline assay results. For fibrinogen, with 4018 CHD cases in 18 studies, comparison of individuals in the top third with those in the bottom third of the baseline measurements yielded a combined risk ratio of 1.8 (95% confidence interval [CI], 1.6-2.0) associated with a difference in long-term usual mean fibrinogen levels of 2.9 pmol/L (0.1 g/dL) between the top and bottom thirds (10.3 vs 7.4 pmol/L [0.35 vs 0.25 g/dL]). For CRP, with 1053 CHD cases in 7 studies, the combined risk ratio of 1.7 (95% CI, 1.4-2.1) was associated with a difference of 1.4 mg/L (2.4 vs 1.0 mg/L). For albumin, with 3770 CHD cases in 8 studies, the combined risk ratio of 1.5 (95% CI, 1.3-1.7) was associated with a difference of 4 g/L (38 vs 42 g/L, ie, an inverse association). For leukocyte count, with 5337 CHD cases in the 7 largest studies, the combined risk ratio of 1.4 (95% CI, 1.3-1.5) was associated with a difference of 2.8 x 10(9)/L (8.4 vs 5.6 x 10(9)/L). Each of these overall results was highly significant (P<.0001). The published results from these prospective studies are remarkably consistent for each factor, indicating moderate but highly statistically significant associations with CHD. Hence, even though mechanisms that might account for these associations are not clear, further study of the relevance of these factors to the causation of CHD is warranted.
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            Fibrinogen as a risk factor for stroke and myocardial infarction.

            K Korsan-Bengtsen, L Welin, L Wilhelmsen … (1984)
            To study the possible risk factors for cardiovascular disease, we collected data on plasma levels of coagulation factors, blood pressure, serum cholesterol, and smoking in a random sample of 792 men 54 years of age. During 13.5 years of follow-up, myocardial infarction occurred in 92 men, stroke in 37, and death from causes other than myocardial infarction or stroke in 60. The blood pressure, degree of smoking, serum cholesterol, and fibrinogen level measured at the base-line examination proved to be significant risk factors for infarction by univariate analyses during follow-up, and blood pressure and fibrinogen were risk factors for stroke. Fibrinogen and smoking were strongly related to each other. The relation between fibrinogen and infarction, and between fibrinogen and stroke, became weaker when blood pressure, serum cholesterol, and smoking habits were taken into account, but was still significant for stroke. Although causality cannot be inferred from these data, it is possible that the fibrinogen level plays an important part in the development of stroke and myocardial infarction.
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              Risk factors for ischemic stroke subtypes: the Atherosclerosis Risk in Communities study.

              Eyal Shahar, Lloyd E. Chambless, Wayne D. Rosamond … (2006)
              To evaluate risk factors for ischemic stroke by its subtypes may contribute to more effective prevention of ischemic stroke, but few prospective studies have characterized risk factors for specific subtypes of ischemic stroke. Between 1987 and 1989, 14,448 men and women aged 45 to 64 years and free of clinical stroke took part in the first examination of the Atherosclerosis Risk in Communities study. The incidence of stroke was ascertained from hospital surveillance records. During an average follow-up of 13.4-years, 531 incident ischemic strokes occurred (105 lacunar, 326 nonlacunar, and 100 cardioembolic). Blacks had a 3-fold higher multivariate-adjusted risk ratio of lacunar stroke compared with whites. No racial difference in nonlacunar or cardioembolic strokes was found after adjusting for prevalent risk factors. In addition to traditional risk factors, nontraditional risk factors, such as waist-to-hip ratio, history of coronary heart disease, left ventricular hypertrophy, lipoprotein(a), and von Willebrand factor, were associated with increased risk for nonlacunar stroke, whereas lacunar stroke was related to only 1 nontraditional risk factor, white blood cell count. The population-attributable fraction (PAF) for hypertension was approximately 35% for all ischemic stroke subtypes. The respective PAFs for diabetes and current smoking were 26.3% and 22.0% for lacunar versus 11.3% and 11.4% for nonlacunar stroke. The PAF for elevated von Willebrand factor was greater than that for current smoking for cardioembolic stroke. The impact of traditional and nontraditional risk factors other than hypertension on the incidence of ischemic stroke varied according to its subtype.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Clin Neurol
                Journal ID (publisher-id): JCN
                Title: Journal of Clinical Neurology (Seoul, Korea)
                Publisher: Korean Neurological Association
                ISSN (Print): 1738-6586
                ISSN (Electronic): 2005-5013
                Publication date (Print): March 2008
                Publication date (Electronic): 20 March 2008
                Volume: 4
                Issue: 1
                Pages: 17-22
                Affiliations
                Department of Neurology, Chonnam National University Medical School, Gwangju, Korea.
                Author notes
                Address for correspondence: Myeong-Kyu Kim, MD, Department of Neurology, Chonnam National University Medical School, 8 Hak-dong, Dong-gu, Gwangju 501-757, Korea. Tel: +82-62-220-6161, Fax: +82-62-228-3461, mkkim@ 123456chonnam.ac.kr
                Article
                DOI: 10.3988/jcn.2008.4.1.17
                PMC ID: 2686883
                PubMed ID: 19513319
                SO-VID: df588bc3-0a7c-491b-9e5e-5e6d1a60eff2
                Copyright © Copyright © 2008 Korean Neurological Association
                History
                Date received : 16 January 2008
                Date accepted : 04 March 2008
                Categories
                Subject: Original Article

                ScienceOpen disciplines: Neurology
                Keywords: polymorphism,fibrinogen,stroke
                Data availability:
                ScienceOpen disciplines: Neurology
                Keywords: polymorphism, fibrinogen, stroke

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