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(Stroke. 2005;36:1852.)
© 2005 American Heart Association, Inc.

Original Contributions

Editorial Comment—Are We in Another Unavoidable ‘Diagnose and Adios’ Era?

Tsong-Hai Lee, MD, PhD, Guest Editor Ku-Chou Chang, MD, Guest Editor

Associate Professor of Neurology, Chief, Stroke Section, Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center, Taiwan Medical College, Chang Gun University, Taiwan
Assistant Professor of Neurology, Department of Neurology, Chang Gung Memorial Hospital Kaohsiung,, Taiwan Medical College, Chang Gung University, Taiwan

Key Words: genetics • stroke management • treatment outcome

An extract of the first 250 words of the full text is provided, because this article has no abstract.

None of us in stroke management regret the passage of the "diagnose and adios" era, humorously criticized earlier. We know well that opportunities for stroke management are arising for more definitive studies. A revolution in imaging, the rush to apply results from clinical trials, and attempts to shorten the time frame for action are daily practice because neurologists are interventionists similar to their colleagues in cardiology and emergency medicine.¹ However, with the pace of accumulated data from leisurely approached genetic association studies, we confront the issue of hereditary risk factors.

In this issue of Stroke, Howard et al² report on a well-organized, population-based study in 15- to 44-year-old women. Among the 5 nitric oxide synthase (NOS)3 polymorphisms in 110 cases (46% black) with ischemic stroke and 206 controls (38% black) who were recruited over 4 years, these investigators found that the –922 G/A and –786 T/C polymorphisms may be associated with ischemic stroke susceptibility among young black women. Although the small sample size precluded extensive analysis, this study highlights the importance of genetic studies of stroke at a young age in different ethnic groups.

Genetic factors may play a role in cerebral vascular disease and may act via endothelial dysfunction, predominantly in the young. NO synthesized by endothelial NOS is a key mediator of endothelial function, and it could be a candidate gene for stroke. The NOS3 intron 4ab insertion/deletion genotype, but not the –786 T/C or the G894T genotype, was reported to be associated with isolated lacunar . . . [Full Text of this Article]

Related Article:

Promoter Polymorphisms in the Nitric Oxide Synthase 3 Gene Are Associated With Ischemic Stroke Susceptibility in Young Black Women

Timothy D. Howard, Wayne H. Giles, Jianfeng Xu, Marcella A. Wozniak, Ann M. Malarcher, Leslie A. Lange, Richard F. Macko, Monica J. Basehore, Deborah A. Meyers, John W. Cole, and Steven J. Kittner
Stroke 2005 36: 1848-1851. [Abstract] [Full Text] [PDF]