This Article Full Text Full Text (PDF) All Versions of this Article: 34/9/e168    most recent 01.STR.0000085085.20390.A3v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Vila, N. Articles by Escudero, D. Search for Related Content PubMed PubMed Citation Articles by Vila, N. Articles by Escudero, D. Related Collections Carotid and Vertebral A. Dissection Genetics of Stroke Risk Factors for Stroke

(Stroke. 2003;34:e168.)
© 2003 American Heart Association, Inc.

Research Reports

Levels of ₁-Antitrypsin in Plasma and Risk of Spontaneous Cervical Artery Dissections

A Case-Control Study

Nicolás Vila, MD; Mónica Millán, MD; Xavier Ferrer, MD; Nadal Riutort, MD Domingo Escudero, MD

From the Departments of Neurology and Clinical Biochemistry Service (N.R.), University Hospital Germans Trías i Pujol, Badalona, Spain

Correspondence to Nicolás Vila, MD, Neurology Service, University Hospital Germans Trías i Pujol, Carretera de Canyet, 08916, Badalona, Spain. E-mail nvila{at}ns.hugtip.scs.es

Background and Purpose— Abnormalities of dermal connective tissue have been detected in patients with spontaneous cervical artery dissections (sCAD), suggesting an underlying structural defect of the arterial wall. ₁-Antitrypsin (A1-AT) is a circulating serine proteinase inhibitor of proteolytic enzymes that helps to maintain the integrity of elastic and collagen fibers.

Methods— To test the hypothesis that moderate deficiency of A1-AT may be a risk factor for sCAD, 22 cases with sCAD and 113 controls were included in the study.

Results— Patients with sCAD had significantly mean lower levels of A1-AT compared with controls (116.0±24.9 versus 141.1±31.7 mg/dL; P<0.01). Low levels of A1-AT (<90 mg/dL) were more frequently observed in patients with sCAD compared with controls (27.3% versus 2.7%; P<0.001). A positive correlation between age and plasma levels of A1-AT was found (r=0.22; P<0.01). A1-AT levels were not affected by sex or vascular risk factors, including smoking habit. On multivariate analysis, A1-AT <90 mg/dL was associated with sCAD independently of age, sex, or vascular risk factors (odds ratio, 17.7; 95% confidence interval, 2.9 to 105.6).

Conclusions— Low plasma levels of A1-AT may be a risk factor for sCAD.

Key Words: alpha 1-antitrypsin • aneurysm, dissecting • risk factors

This article has been cited by other articles:

				C. Grond-Ginsbach, S. Engelter, I. Werner, I. Hausser, U. S. Muller, T. Brandt, and P. Lyrer Alpha-1-antitrypsin deficiency alleles are not associated with cervical artery dissections Neurology, April 13, 2004; 62(7): 1190 - 1192. [Abstract] [Full Text] [PDF]