Abstract P304: Association of Stroke Risk Biomarkers With Stroke Symptoms: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Cohort
Background: History of stroke symptoms (SS) in the absence of prior stroke or TIA is associated with adverse stroke risk profile and future stroke risk. Biomarkers associated with inflammation, cardiac function and hemostatic function are also associated with stroke prevalence and incidence. Better understanding of the relationship between SS and these biomarkers will allow hypothesis formation on the biologic underpinnings of SS.
Hypothesis: Higher levels of D-dimer, C-reactive protein (CRP), fibrinogen, factor VIII, and factor XI and NT-proBNP are associated with prevalent SS.
Methods: REGARDS enrolled 30,239 black and white participants age 45 and older from the contiguous US to study geographic and racial differences in stroke. We performed a cross-sectional study in a random sample of 1100 participants in which the above biomarkers were measured. Prevalent SS at baseline were ascertained using the Questionnaire for Verifying Stroke-free Status. Excluding those with pre-baseline stroke or TIA, there were 190 participants with self-reported SS and 770 without these. Odds ratios of prevalence of any SS by quartiles and per SD increment of each biomarker were calculated using logistic regression.
Results: Adjusting for age, race and sex, NT-proBNP, CRP and D-dimer in the top vs bottom quartile were associated with history of any SS (ORs: 3.45 (95%CI: 2.00-5.95), 2.38 (95%CI: 1.49-3.82), and 1.81 (95%CI:1.03-3.17), respectively), as were SD increments of these and factor XI. Odds ratios with added adjustment for Framingham stroke risk factors were little changed and are shown in the table.
Summary: Higher levels of NT- proBNP, CRP, factor XI and D-dimer are each associated with prevalent SS. Results provide further evidence that history of SS may represent cerebrovascular disease. Future work is needed to determine whether these biomarkers identify persons with a history of SS who are at particularly high stroke risk.
Author Disclosures: K.M. Klingman: None. K. Alexander: None. N. Zakai: None. S.E. Judd: None. D.O. Kleindorfer: None. V.J. Howard: None. G. Howard: None. M. Cushman: None.
- © 2015 by American Heart Association, Inc.