ARCH PLAQUES AND STROKE IN AN ETHNICALLY MIXED COMMUNITY

描述：（改编自申请人摘要）。 动脉粥样硬化斑块 主动脉弓中的动脉粥样硬化被认为是缺血性心脏病的潜在原因。 老年人中风 动脉弓粥样硬化在不同的 种族-族裔群体不详。 此外，拱门的组合 动脉粥样硬化与血脂紊乱或高凝状态，这可能会提高他们的 栓塞可能性，尚未研究。 以人口为基础， 拟进行病例对照研究，以解决以下具体目标：1） 确定主动脉弓粥样硬化是否是缺血性卒中的危险因素 在老年人中，以及他们在不同种族-族裔亚群体中的重要性; 和2）确定主动脉弓粥样硬化是否与脂质相关 异常或高凝状态。 次要目的将是评价4年卒中复发风险， 总体组中有和无动脉粥样硬化的患者， 种族-种族亚组，以及与 动脉粥样化的形态学特征（存在溃疡或 移动的组件）。 共有300例缺血性卒中和300例无卒中对照， 年龄、性别和种族匹配的患者将入组本5年期研究。 基于人群的病例对照研究。 研究受试者将从 正在进行的北方曼哈顿卒中研究（NoMaSS）将确保 招聘和提供其他数据收集。 拱的存在 动脉粥样化将通过经食管超声心动图来确定。 脂质 测试将包括总胆固醇，甘油三酯，高密度脂蛋白和低密度脂蛋白 胆固醇、脂蛋白（a）、载脂蛋白A-I和B。高凝 测试将包括纤维蛋白原，凝血酶原片段F1+2和狼疮 抗凝剂 每年将对病例进行电话随访， 控制以确定死亡率和中风。 条件logistic回归 将用于计算主动脉弓卒中的校正比值比 整个研究组中的动脉粥样硬化，并按种族-民族分层 分组。 这项研究将为中风病理生理学提供重要数据 并为临床试验奠定基础，以评估治疗效果 治疗中风和主动脉弓动脉粥样硬化的老年患者的选择。

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.