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Increased Incidence of Ischemic Cerebrovascular Events in Cardiovascular Patients With Elevated Apolipoprotein CIII
- Source :
- Stroke. 51:61-68
- Publication Year :
- 2020
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2020.
-
Abstract
- Background and Purpose— Apo CIII (apolipoprotein CIII), a crucial regulator of lipoprotein metabolism, has been associated with increased activity of coagulation factors and thrombin generation and, in turn, with an increased risk of thromboembolic events in both arterial and venous districts. Thus, we hypothesized that it may affect the risk of acute ischemic cerebrovascular events in cardiovascular patients. Methods— We systematically checked medical records and quantified cerebral ischemic events in a cohort of 950 subjects (median age 65 with interquartile range, 55–79 years; 30.7% females) with or without angiographically defined coronary artery disease (CAD: 774 CAD and 176 CAD-free, respectively). All the subjects, enrolled between May 1999 and December 2006, were prospectively followed until death or July 31, 2018. Assessments of complete plasma lipid and apolipoprotein profiles, including Apo A-I, B, CIII, and E, were available for all subjects at enrollment. Results— After a median follow-up of 130 months (interquartile range, 69–189), 95 subjects (10%) suffered ischemic stroke/transient ischemic attack (TIA) events. Stroke/TIA subjects had higher Apo CIII plasma concentration (11.4; interquartile range: 9.3–14.4 mg/dL) at enrollment than those without stroke/TIA (10.4, interquartile range: 8.7–13.0 mg/dL). Subjects with Apo CIII levels above the median value (10.6 mg/dL) exhibited an ≈2-fold increased risk of stroke/TIA, even after adjustment for potential confounders, including sex, age, CAD diagnosis, hypertension, atrial fibrillation, oral anticoagulant treatment, and all plasma lipid parameters (hazard ratio: 2.23 [95% CI, 1.21–4.13]). This result was confirmed in CAD and CAD-free populations, separately, and even by a propensity score matching method, in which 98 CAD and 98 CAD-free subjects were one-to-one matched for all clinical and laboratory characteristics. Conclusions— These findings suggest that a high Apo CIII plasma concentration may predict an increased risk of ischemic stroke/TIA in cardiovascular patients.
- Subjects :
- Male
medicine.medical_specialty
Regulator
Coronary Artery Disease
Coronary Angiography
Thrombin generation
lipids
Cohort Studies
Coronary artery disease
Risk Factors
Internal medicine
Atrial Fibrillation
Humans
Medicine
Lipoprotein metabolism
cardiovascular diseases
Aged
Advanced and Specialized Nursing
apolipoproteins
coronary artery disease
ischemic cerebrovascular events
Apolipoprotein C-III
business.industry
Incidence
Incidence (epidemiology)
Middle Aged
medicine.disease
Stroke
Endocrinology
Coagulation
Ischemic Attack, Transient
Female
lipids (amino acids, peptides, and proteins)
Neurology (clinical)
Apolipoprotein CIII
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 15244628 and 00392499
- Volume :
- 51
- Database :
- OpenAIRE
- Journal :
- Stroke
- Accession number :
- edsair.doi.dedup.....ad2d88897849ebe50e431f0374dc9244