STROKE M.I. AND ANTIPHOSPHOLIPID ANTIBODIES

描述：(改编自申请者摘要)这项工作的总体目标 项目是定义病理生理机制，通过它 抗磷脂抗体(APL)是血管疾病的危险因素。这个 假设APL是缺血性卒中和心肌梗死的预测因子 老年男性和女性的脑梗塞(MI)，但与 动脉粥样硬化的进展。一项嵌套式病例对照研究建议在 心血管健康研究(CHS)队列(5201名男性和女性)和CHS 非裔美国人队列(687名男性和女性)。存储的冷冻基线血清和 心血管危险因素数据，包括止血措施和 炎症和内膜-中层厚度(IMT)的改变已经存在 关于所有研究参与者的信息。研究人群中，所有65岁或以上的人 基线，将包括370例发生缺血性中风的患者，370例 事件心肌梗死和1480个种族匹配的对照。允许通过以下方式进行分层 急性早幼粒细胞白血病作为亚临床进展预测因子的分析 动脉粥样硬化，另外300名没有中风或心肌梗塞病史的人 将从非裔美国人队列中抽样。血液也将被送往 德克萨斯大学圣安东尼奥分校提供最先进的APL测定。 主要研究将使用Logistic模型和线性回归模型进行检验 假设。这项研究的结果将证实APL作为主要的 老年男性和老年人临床和亚临床血管疾病的危险因素 并确定与血管疾病的关联是否被中介 由其他已知的风险因素造成。这些发现将对设计 未来的研究试图澄清免疫系统与 血管疾病。

DESCRIPTION: (Adapted from Applicant's Abstract) The overall goal of this project is to define the pathophysiologic mechanism through which antiphospholipid antibodies (aPL) act as risk factors for vascular disease. The hypothesis is that aPL are predictors of ischemic stroke and myocardial infarction (MI) in elderly men and women, yet are not associated with progression of atherosclerosis. A nested case-control study is proposed within the Cardiovascular Health Study (CHS) cohort (5,201 men and women) and CHS African-American cohort (687 men and women). Stored frozen baseline sera and cardiovascular risk factor data including measures of hemostasis and inflammation and change in intimal-medial thickness (IMT) are already available on all study participants. The study population, all 65 years or older at baseline, will consist of 370 cases with incident ischemic stroke, 370 cases with incident MI, and 1,480 race-matched controls. To allow stratification by race in the analyses of aPL as predictors of progression of subclinical atherosclerosis, an additional 300 persons without a history of stroke or MI will be sampled from the African-American cohort. Blood will also be sent to the University of Texas at San Antonio for state-of-the-art aPL determinations. Logistic and linear regression models will be used to test major study hypotheses. The results of this study will confirm the role of aPL as major risk factors for clinical and subclinical vascular diseasse in elderly men and women and determine whether the association with vascular disease is mediated by other known risk factors. These findings will be vital in the design of future studies that seek to clarify the relationship of the immune system to vascular disease.