ARCH PLAQUES AND STROKE IN AN ETHNICALLY MIXED COMMUNITY

种族混合社区中的拱形斑块和中风

• 批准号: 6393527
• 负责人: MARCO R DI TULLIO
• 金额: $ 38.06万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-06-01 至 2004-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6393527
• 关键词: aorta obstruction; apolipoproteins; atherosclerotic plaque; blood chemistry; blood coagulation; blood lipoprotein; cardiovascular disorder epidemiology; cholesterol; clinical research; disease /disorder etiology; disease /disorder proneness /risk; echocardiography; high density lipoproteins; human morbidity; human mortality; human old age (65+); human subject; ischemia; lipid disorder; longitudinal human study; low density lipoprotein; racial /ethnic difference; stroke; triglycerides

DESCRIPTION: (Adapted from Applicant's Abstract). Atherosclerotic plaques (atheromas) in the aortic arch are considered a potential cause for ischemic stroke in the elderly. The impact of arch atheromas in different racial-ethnic groups is unknown. Moreover, the association of arch atheromas with lipid disorders or hypercoagulability, that may enhance their embolic potential, has not been investigated. A population-based, case-control study is proposed to address the following Specific Aims: 1) to determine if aortic arch atheromas are a risk factor for ischemic stroke in the elderly, and their importance in different racial-ethnic subgroups; and 2) to determine if aortic arch atheromas are associated with lipid abnormalities or hypercoagulable states in elderly stroke patients. Secondary Aims will be to evaluate the 4-year stroke recurrence risk in patients with and without atheromas in the overall group and by racial-ethnic subgroups, and the additional risk associated with morphological characteristics of the atheroma (presence of ulcerations or mobile components). A total of 300 cases of ischemic stroke and 300 stroke-free controls, matched by age, gender and race will be enrolled in this 5-year population-based case-control study. Study subjects will be drawn from the ongoing Northern Manhattan Stroke Study (NoMaSS), which will assure recruitment and provide other data collection. The presence of arch atheromas will be ascertained by transesophageal echocardiography. Lipid tests will include total cholesterol, triglycerides, HDL and LDL cholesterol, lipoprotein (a), apolipoproteins A-I and B. Hypercoagulability tests will include fibrinogen, prothrombin fragment F1+2 and lupus anticoagulant. Annual telephone follow-up will be performed on cases and controls to ascertain mortality and stroke. Conditional logistic regression will be used to calculate the adjusted odds ratio for stroke of aortic arch atheromas in the overall study group and stratified by racial-ethnic subgroups. The study will provide important data on stroke pathophysiology and set the ground for clinical trials to assess the efficacy of therapeutic options in treating elderly patients with stroke and aortic arch atheromas.

描述：（改编自申请人的摘要）。 动脉粥样硬化斑块 （动脉瘤）主动脉弓中被认为是缺血性的潜在原因 老年人中风。 弓动脉瘤在不同的影响 种族族群尚不清楚。 而且，拱门协会 具有脂质疾病或高凝性的动脉瘤，可能会增强其 栓塞潜力尚未进行研究。 一个基于人群的 提出了病例对照研究以解决以下特定目的：1） 确定主动脉弓动脉瘤是否是缺血性中风的危险因素 在老年人中及其在不同种族 - 种族亚组中的重要性； 2）确定主动脉弓动脉瘤是否与脂质有关 老年人中风患者的异常或高凝状态。 次要目标是评估4年中风复发风险 整个组中有和没有动脉瘤的患者以及 种族族裔亚组，以及与 动脉瘤的形态学特征（存在溃疡或 移动组件）。 总共300例缺血性中风和300例无中风对照， 按年龄，性别和种族匹配，将参加这五年 基于人群的病例对照研究。 研究科目将从 正在进行的曼哈顿北部中风研究（NOMASS），这将确保 招聘并提供其他数据收集。 拱门的存在 动脉瘤将通过经食管超声心动图确定。 脂质 测试将包括总胆固醇，甘油三酸酯，HDL和LDL 胆固醇，脂蛋白（A），载脂蛋白A-I和B。 测试将包括纤维蛋白原，凝血酶原片段F1+2和狼疮 抗凝物。 每年的电话随访将在案件和 控制死亡率和中风。 有条件的逻辑回归 将用于计算主动脉弓中风的调整后比值比 整体研究组的动脉瘤，并按种族种族分层 亚组。 该研究将提供有关中风病理生理学的重要数据 并为评估治疗的疗效的临床试验奠定基础 治疗中风和主动脉弓动脉瘤的老年患者的选择。