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29. Levels of acute phase proteins remain stable after ischemic stroke

Author

Paik Myunghee C, Tai Wanling, Coates Kristen, Elkind Mitchell SV, Boden-Albala Bernadette, and Sacco Ralph L

Subjects
Neurology. Diseases of the nervous system, RC346-429
Abstract

Abstract Background Inflammation and inflammatory biomarkers play an important role in atherosclerosis and cardiovascular disease. Little information is available, however, on time course of serum markers of inflammation after stroke. Methods First ischemic stroke patients ≥40 years old had levels of high-sensitivity C-reactive protein (hsCRP), serum amyloid A (SAA), and fibrinogen measured in plasma samples drawn at 1, 2, 3, 7, 14, 21 and 28 days after stroke. Levels were log-transformed as needed, and parametric and non-parametric statistical tests were used to test for evidence of a trend in levels over time. Levels of hsCRP and SAA were also compared with levels in a comparable population of stroke-free participants. Results Mean age of participants with repeated measures (n = 21) was 65.6 ± 11.6 years, and 13 (61.9%) were men, and 15 (71.4%) were Hispanic. Approximately 75% of patients (n = 15) had mild strokes (NIH Stroke Scale score 0–5). There was no evidence of a time trend in levels of hsCRP, SAA, or fibrinogen for any of the markers during the 28 days of follow-up. Mean log(hsCRP) was 1.67 ± 1.07 mg/L (median hsCRP 6.48 mg/L) among stroke participants and 1.00 ± 1.18 mg/L (median 2.82 mg/L) in a group of 1176 randomly selected stroke-free participants from the same community (p = 0.0252). Conclusion Levels of hsCRP are higher in stroke patients than in stroke-free subjects. Levels of inflammatory biomarkers associated with atherosclerosis, including hsCRP, appear to be stable for at least 28 days after first ischemic stroke.

Published
2006
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40. CKD Associates with Cognitive Decline

Author

Khatri, Minesh, primary, Nickolas, Thomas, additional, Moon, Yeseon P., additional, Paik, Myunghee C., additional, Rundek, Tatjana, additional, Elkind, Mitchell S. V., additional, Sacco, Ralph L., additional, and Wright, Clinton B., additional

Published
2009
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46. Stroke Incidence among White, Black, and Hispanic Residents of an Urban Community.

Author

Sacco, Ralph L., Boden-Albala, Bernadette, Gan, Robert, Chen, Xun, Kargman, Douglas E., Shea, Steven, Paik, Myunghee C., and Hauser, W. Allen

Subjects
STROKE, WHITE people, CEREBROVASCULAR disease
Abstract

Stroke mortality is reported to be greater in blacks than in whites, but stroke incidence data for blacks and Hispanics are sparse. The aim of this study was to determine and compare stroke incidence rates among whites, blacks, and Hispanics living in the same urban community. A population-based incidence study was conducted to identify all cases of first stroke occurring in northern Manhattan, New York City, between July 1, 1993, and June 30, 1996. The population of this area was approximately 210, 000 at that time, based on 1990 US Census data. Surveillance for hospitalized and nonhospitalized stroke consisted of daily screening of all admissions, discharges, and computed tomography logs at Columbia-Presbyterian Medical Center, the only hospital in the region, and review of discharge lists from outside hospitals, telephone surveys of random households, and contacts with community physicians, Visiting Nurses' Services, and community agencies. Stroke incidence increased with age and was greater in men than in women. The average annual age-adjusted stroke incidence rate at age ≥20 years, per 100, 000 population, was 223 for blacks, 196 for Hispanics, and 93 for whites. Blacks had a 2.4-fold and Hispanics a twofold increase in stroke incidence compared with whites. Cerebral infarct accounted for 77 percent of all strokes, intracerebral hemorrhage for 17 percent, and subarachnoid hemorrhage for 6 percent. These data from the Northern Manhattan Stroke Study suggest that part of the reported excess stroke mortality among blacks in the United States may be a reflection of racial/ethnic differences in stroke incidence. Am J Epidemiol 1998; 147: 259–68. [ABSTRACT FROM AUTHOR]

Published
1998

47. High-Sensitivity C-Reactive Protein and Lipoprotein-Associated Phospholipase A2Stability Before and After Stroke and Myocardial Infarction

Author

Elkind, Mitchell S.V., Leon, Vladimir, Moon, Yeseon P., Paik, Myunghee C., and Sacco, Ralph L.

Abstract

High-sensitivity C-reactive protein (hsCRP) and lipoprotein-associated phospholipase A2(Lp-PLA2) are hypothesized to be biomarkers of systemic inflammation and risk of myocardial infarction (MI) and stroke. Little is known, however, about the stability of these markers over time, and in particular, about the effects of acute vascular events on these marker levels.

Published
2009
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48. Improving Global Vascular Risk Prediction With Behavioral and Anthropometric Factors The Multiethnic NOMAS (Northern Manhattan Cohort Study)

Author

Sacco, Ralph L., Khatri, Minesh, Rundek, Tatjana, Xu, Qiang, Gardener, Hannah, Boden-Albala, Bernadette, Di Tullio, Marco R., Homma, Shunichi, Elkind, Mitchell S.V., and Paik, Myunghee C.

Subjects
prevention, cardiovascular disease, risk factors, epidemiology, cerebrovascular disease
Abstract

ObjectivesThis study sought to improve global vascular risk prediction with behavioral and anthropometric factors.BackgroundFew cardiovascular risk models are designed to predict the global vascular risk of myocardial infarction, stroke, or vascular death in multiethnic individuals, and existing schemes do not fully include behavioral risk factors.MethodsA randomly derived, population-based, prospective cohort of 2,737 community participants free of stroke and coronary artery disease was followed up annually for a median of 9.0 years in the NOMAS (Northern Manhattan Study) (mean age 69 years, 63.2% women, 52.7% Hispanic, 24.9% African American, and 19.9% white). A global vascular risk score (GVRS) predictive of stroke, myocardial infarction, or vascular death was developed by adding variables to the traditional Framingham cardiovascular variables based on the likelihood ratio criteria. Model utility was assessed through receiver-operating characteristics, calibration, and effect on reclassification of subjects.ResultsVariables that significantly added to the traditional Framingham profile included waist circumference, alcohol consumption, and physical activity. Continuous measures for blood pressure and fasting blood sugar were used instead of hypertension and diabetes. Ten-year event-free probabilities were 0.95 for the first quartile of GVRS, 0.89 for the second quartile, 0.79 for the third quartile, and 0.56 for the fourth quartile. The addition of behavioral factors in our model improved prediction of 10-year event rates compared with a model restricted to the traditional variables.ConclusionsA GVRS that combines traditional, behavioral, and anthropometric risk factors; uses continuous variables for physiological parameters; and is applicable to nonwhite subjects could improve primary prevention strategies.

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49. Abstract 54.

Author

Katan, Mira, Moon, Yeseon P, Derosa, Janet, Paik, Myunghee C, Mueller, Beat, Herklotz, Roberto, Sacco, Ralph L, and Elkind, Mitchell S

Published
2014

50. Abstract 2552.

Author

Katan, Mira, Moon, Yeseon P, Gervasi-Franklin, Palma, Paik, Myunghee C, Wolfert, Robert L, Sacco, Ralph L, and Elkind, Mitchell S

Published
2012

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