From the Departments of Neurology (S.J.K, B.R.F, R.F.M., T.R.P., M.A.S.,
M.A.W.) and Epidemiology and Preventive Medicine (S.J.K., R.J.M., T.R.P.,
M.A.S., P.D.S.), University of Maryland at Baltimore; the Departments of
Neurology (D.W.B., C.J.E., C.J.J., K.R.W., R.J.W.) and Medicine (P.J.G.-C.,
P.F.B.), Johns Hopkins University, Baltimore, Md; Cardiovascular Health
Branch, National Center for Chronic Disease Prevention and Health Promotion
(J.B.C., W.H.G.) and Division of Environmental Health Laboratory Sciences,
National Center for Environmental Health (V.K.B, C.-Y.O.), Centers for Disease
Control and Prevention, Atlanta, Ga; and the Department of Neurology (B.J.S.)
Emory University, Atlanta, Ga.
Correspondence to Steven J. Kittner, MD, MPH, Bressler Bldg, Room 12–013, UMAB, 655 W Baltimore St, Baltimore, MD 21201. E-mail skittner{at}umabnet.ab.umd.edu
Background and
Purpose—Platelet glycoprotein IIb/IIIa
(GpIIb-IIIa), a membrane receptor for fibrinogen and von
Willebrand factor, has been implicated in the pathogenesis of
acute coronary syndromes but has not been previously
investigated in relation to stroke in young adults.
Methods—We used a population-based case-control design to examine
the association of the GpIIIa polymorphism P1A2 with stroke in
young women. Subjects were 65 cerebral infarction cases (18 patients
with and 47 without an identified probable etiology) 15 to 44 years of
age from the Baltimore-Washington region and 122 controls frequency
matched by age from the same geographic area. A face-to-face interview
for vascular disease risk factors and a blood sample for the P1A2
allele and serum cholesterol were obtained from each
participant. Logistic regression was used to estimate the odds ratio
for one or more P1A2 alleles after adjustment for other risk
factors.
Results—Among cases and controls, the prevalence rates of one or
more P1A2 alleles were 21% and 22% among blacks and 36% and 28%
among whites, respectively. This genotype was significantly
associated with hypertension only in black control subjects but
otherwise not with any of the established vascular risk factors. The
adjusted odds ratio for cerebral infarction of one or more P1A2
alleles was 1.1 (confidence interval [CI], 0.6 to 2.3) overall,
0.5 (CI, 0.1 to 7.1) among blacks, and 1.4 (CI, 0.5 to 3.7) among
whites. For the cases with an identified probable etiology, the
corresponding odds ratios were 3.0 (CI, 0.9 to 10.4) overall, 0.7 (CI,
0.1 to 7.1) among blacks, and 12.8 (CI, 1.2 to 135.0) among whites.
Conclusions—No association was found between the P1A2
polymorphism of GpIIIa and young women with stroke. However,
subgroup analyses showed that the P1A2 polymorphism of
GpIIIa appeared to be associated with stroke risk among white women,
particularly those with a clinically identified probable etiology for
their stroke. Further work with an emphasis on stroke subtypes and with
multiracial populations is warranted.
© 1998 American Heart Association, Inc.
Original Contributions
Platelet Glycoprotein Receptor IIIa Polymorphism P1A2 and Ischemic Stroke Risk
The Stroke Prevention in Young Women Study
Key Words: cerebrovascular disorders • platelets • polymorphism (genetics) • young adults • women
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