BACKGROUND: Inflammatory and hemostasis-related biomarkers may identify women at risk of stroke. METHODS: Hormones and Biomarkers Predicting Stroke is a study of ischemic stroke among postmenopausal women participating in the Women's Health Initiative observational study (n = 972 case-control pairs). A Biomarker Risk Score (BRS) was derived from levels of 7 inflammatory and hemostasis-related biomarkers that appeared individually to predict risk of ischemic stroke: C-reactive protein (CRP), interleukin-6, tissue plasminogen activator, D-dimer, white blood cell count, neopterin, and homocysteine. The c index was used to evaluate discrimination. RESULTS: Of all the individual biomarkers examined, CRP emerged as the only independent single predictor of ischemic stroke (adjusted odds ratio comparing Quartile(4)v Quartile(1) = 1.64, 95% confidence interval: 1.15-2.32, P = .01) after adjustment for other biomarkers and standard stroke risk factors. The BRS identified a gradient of increasing stroke risk with a greater number of elevated inflammatory/hemostasis biomarkers, and improved the c index significantly compared with standard stroke risk factors (P = .02). Among the subset of individuals who met current criteria for high-risk levels of CRP (>3.0 mg/L), the BRS defined an approximately 2-fold gradient of risk. We found no evidence for a relationship between stroke and levels of E-selectin, fibrinogen, tumor necrosis factor-alpha, vascular cell adhesion molecule-1, prothrombin fragment 1+2, Factor VIIC, or plasminogen activator inhibitor-1 antigen (P > .15). DISCUSSION: The findings support the further exploration of multiple biomarker panels to develop approaches for stratifying an individual's risk of stroke.
BACKGROUND: Inflammatory and hemostasis-related biomarkers may identify women at risk of stroke. METHODS: Hormones and Biomarkers Predicting Stroke is a study of ischemic stroke among postmenopausal women participating in the Women's Health Initiative observational study (n = 972 case-control pairs). A Biomarker Risk Score (BRS) was derived from levels of 7 inflammatory and hemostasis-related biomarkers that appeared individually to predict risk of ischemic stroke: C-reactive protein (CRP), interleukin-6, tissue plasminogen activator, D-dimer, white blood cell count, neopterin, and homocysteine. The c index was used to evaluate discrimination. RESULTS: Of all the individual biomarkers examined, CRP emerged as the only independent single predictor of ischemic stroke (adjusted odds ratio comparing Quartile(4)v Quartile(1) = 1.64, 95% confidence interval: 1.15-2.32, P = .01) after adjustment for other biomarkers and standard stroke risk factors. The BRS identified a gradient of increasing stroke risk with a greater number of elevated inflammatory/hemostasis biomarkers, and improved the c index significantly compared with standard stroke risk factors (P = .02). Among the subset of individuals who met current criteria for high-risk levels of CRP (>3.0 mg/L), the BRS defined an approximately 2-fold gradient of risk. We found no evidence for a relationship between stroke and levels of E-selectin, fibrinogen, tumor necrosis factor-alpha, vascular cell adhesion molecule-1, prothrombin fragment 1+2, Factor VIIC, or plasminogen activator inhibitor-1 antigen (P > .15). DISCUSSION: The findings support the further exploration of multiple biomarker panels to develop approaches for stratifying an individual's risk of stroke.
Authors: Thomas A Pearson; George A Mensah; R Wayne Alexander; Jeffrey L Anderson; Richard O Cannon; Michael Criqui; Yazid Y Fadl; Stephen P Fortmann; Yuling Hong; Gary L Myers; Nader Rifai; Sidney C Smith; Kathryn Taubert; Russell P Tracy; Frank Vinicor Journal: Circulation Date: 2003-01-28 Impact factor: 29.690
Authors: Nancy S Jenny; Russell P Tracy; Malcolm S Ogg; Le Ahn Luong; Lewis H Kuller; Alice M Arnold; A Richey Sharrett; Steve E Humphries Journal: Arterioscler Thromb Vasc Biol Date: 2002-12-01 Impact factor: 8.311
Authors: John Danesh; Jeremy G Wheeler; Gideon M Hirschfield; Shinichi Eda; Gudny Eiriksdottir; Ann Rumley; Gordon D O Lowe; Mark B Pepys; Vilmundur Gudnason Journal: N Engl J Med Date: 2004-04-01 Impact factor: 91.245
Authors: Matteo Cesari; Brenda W J H Penninx; Anne B Newman; Stephen B Kritchevsky; Barbara J Nicklas; Kim Sutton-Tyrrell; Susan M Rubin; Jingzhong Ding; Eleanor M Simonsick; Tamara B Harris; Marco Pahor Journal: Circulation Date: 2003-10-20 Impact factor: 29.690
Authors: Matteo Cesari; Brenda W J H Penninx; Anne B Newman; Stephen B Kritchevsky; Barbara J Nicklas; Kim Sutton-Tyrrell; Russell P Tracy; Susan M Rubin; Tamara B Harris; Marco Pahor Journal: Am J Cardiol Date: 2003-09-01 Impact factor: 2.778
Authors: Jie J Cao; Chau Thach; Teri A Manolio; Bruce M Psaty; Lewis H Kuller; Paulo H M Chaves; Joseph F Polak; Kim Sutton-Tyrrell; David M Herrington; Thomas R Price; Mary Cushman Journal: Circulation Date: 2003-06-23 Impact factor: 29.690
Authors: Aruna D Pradhan; JoAnn E Manson; Jacques E Rossouw; David S Siscovick; Charles P Mouton; Nader Rifai; Robert B Wallace; Rebecca D Jackson; Mary B Pettinger; Paul M Ridker Journal: JAMA Date: 2002-08-28 Impact factor: 56.272
Authors: Robert C Kaplan; Gloria Y F Ho; XiaoNan Xue; Swapnil Rajpathak; Mary Cushman; Thomas E Rohan; Howard D Strickler; Philipp E Scherer; Kathryn Anastos Journal: Cancer Epidemiol Biomarkers Prev Date: 2007-06 Impact factor: 4.254
Authors: Unab I Khan; Alexandra D Ogorodnikova; Linzhi Xu; Dan Wang; Sylvia Wassertheil-Smoller; Gloria Y F Ho; Mary Fran R Sowers; Swapnil N Rajpathak; Matthew A Allison; Rachel H Mackey; Mara Z Vitolins; Joann E Manson; Rachel P Wildman Journal: Obesity (Silver Spring) Date: 2013-12-20 Impact factor: 5.002
Authors: Rachel P Wildman; Robert Kaplan; JoAnn E Manson; Aleksandar Rajkovic; Stephanie A Connelly; Rachel H Mackey; Lesley F Tinker; J David Curb; Charles B Eaton; Sylvia Wassertheil-Smoller Journal: Obesity (Silver Spring) Date: 2011-01-13 Impact factor: 5.002
Authors: Swapnil N Rajpathak; Tao Wang; Sylvia Wassertheil-Smoller; Howard D Strickler; Robert C Kaplan; Aileen P McGinn; Rachel P Wildman; Daniel Rosenbaum; Thomas E Rohan; Philipp E Scherer; Mary Cushman; Gloria Y F Ho Journal: Stroke Date: 2010-03-04 Impact factor: 7.914
Authors: Elizabeth Crabb Breen; Sandra M Reynolds; Christopher Cox; Lisa P Jacobson; Larry Magpantay; Candice B Mulder; Oliver Dibben; Joseph B Margolick; Jay H Bream; Elise Sambrano; Otoniel Martínez-Maza; Elizabeth Sinclair; Persephone Borrow; Alan L Landay; Charles R Rinaldo; Philip J Norris Journal: Clin Vaccine Immunol Date: 2011-06-22
Authors: Charles X Kim; Kent R Bailey; George G Klee; Allison A Ellington; Guanghui Liu; Thomas H Mosley; Hamid Rehman; Iftikhar J Kullo Journal: PLoS One Date: 2010-02-05 Impact factor: 3.240
Authors: Bas C T van Bussel; Isabel Ferreira; Marjo P H van de Waarenburg; Marleen M J van Greevenbroek; Carla J H van der Kallen; Ronald M A Henry; Edith J M Feskens; Coen D A Stehouwer; Casper G Schalkwijk Journal: PLoS One Date: 2013-03-05 Impact factor: 3.240