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  • Ovid Technologies (Wolters Kluwer Health)  (2)
  • Kelly-Hayes, Margaret  (2)
  • Wolf, Philip A  (2)
  • English  (2)
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  • Ovid Technologies (Wolters Kluwer Health)  (2)
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  • English  (2)
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  • 1
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 44, No. suppl_1 ( 2013-02)
    Abstract: Objective: To examine the association of serum VEGF levels with incident stroke and transient ischemic attack (TIA) in a large, community-based cohort. Background: VEGF, an endothelial growth factor promotes angiogenesis and neurogenesis and has demonstrated neuroprotective properties in animal experiments. However, high circulating VEGF levels have also been observed in patients with vascular risk factors, atherosclerosis and in small studies of acute stroke. There have been no studies examining the association of serum VEGF with the risk of stroke in a community-based sample. Methods: In 3440 stroke/TIA-free FHS participants (mean age 65+11yrs, 56%W), we related baseline VEGF (log-transformed) to risk of incident stroke/TIA. To examine the incremental utility of VEGF over age-, sex- and baseline Framingham Stroke Risk Profile (FSRP) in predicting stroke/TIA, we also calculated the net reclassification improvement (NRI). Results: During a median follow-up of 10 years, 193 participants experienced incident stroke/TIA (129 ischemic strokes). In multivariable analyses adjusted for age-, sex- and traditional stroke risk factors (as identified by the FSRP), higher logVEGF levels were associated with an increased risk of incident stroke/TIA (HR/1SD increase in logVEGF: 1.21, 95%CI: 1.04-1.40, p=0.012). This was also true for incident ischemic stroke events (HR/1SD increase in logVEGF: 1.21 95%CI: 1.01-1.44 p=0.04). In reclassification analyses, logVEGF, when added to a risk assessment model based on the FSRP resulted in significant improvement of risk prediction with NRI of 0.046 (p=0.036). Interpretation: After adjusting for traditional stroke risk factors, higher VEGF concentrations were associated with increased risk of incident stroke/TIA, suggesting that VEGF may serve as a novel risk marker for stroke/TIA and to improve risk stratification permitting more targeted preventive interventions.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2013
    detail.hit.zdb_id: 1467823-8
    Location Call Number Limitation Availability
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  • 2
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 32, No. suppl_1 ( 2001-01), p. 330-331
    Abstract: 83 Background: The role of plasma C-reactive protein (CRP) as marker of cerebrovascular risk is currently under investigation. We evaluated relative risk of developing first ischemic stroke and TIA among the patients with elevated systolic blood pressure (SBP) and/or elevated plasma CRP levels versus those patients with unelevated SBP and unelevated CRP. Methods: We studied 591 men and 868 women of the original Framingham Study cohort who were free of stroke and TIA at the time of their 1980–1982 clinic exam. Sex-specific Cox proportional hazards regressions were used to quantify the risk of 14-year incidence of ischemic stroke/TIA associated with elevated SBP and CRP. Unadjusted models and models adjusted for age, smoking, total & HDL cholesterol, and diabetes were used. SBP and CRP were included in the Cox models as sex-specific quartiles. Risk ratios of first ischemic stroke/TIA for individuals with elevated (in the upper quartile) SBP (SBP+) and CRP (CRP+) were determined using the SBP-/CRP- individuals as a reference group. Similarly, simultaneous evaluation of the risk of first ischemic stroke/TIA was done for SBP+/CRP- and SBP-/CRP+ using the individuals in SBP-/CRP- as a reference group. Results: Relative to SBP-/CRP- men (incidence of first ischemic stroke/TIA of 36/328, or 11.0%), SBP+/CRP+ men (where incidence was 8/32, or 25.0%) had unadjusted risk ratio of 3.56 (p=0.001). This ratio was nearly twice that for SBP+/CRP- men (incidence=20/115, or 17.4%; RR=1.89, p=0.023). Relative to SBP-/CRP- women (incidence= 45/485, or 9.3%), the unadjusted risk ratio increased from 2.03 in SBP+/CRP- women (incidence=27/166, or 16.3%; p=0.001) to 3.44 in SBP+/CRP+ women (incidence=15/58, or 25.9%; p 〈 0.001). Adjustment for age did not significantly alter this relationship. Following multivariate adjustment, risk of developing first ischemic stroke/TIA remained significantly elevated in SBP+/CRP+ men (RR=2.7; p=0.018) and women (RR=2.06; p=0.027). Conclusion: Having both CRP levels and systolic BP above the 75 th percentile for each of these parameters significantly increased risk of developing first ischemic stroke/TIA in both sexes.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2001
    detail.hit.zdb_id: 1467823-8
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
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