Hormones and Biomarkers Predicting Stroke in Women

预测女性中风的激素和生物标志物

• 批准号: 6935357
• 负责人: Sylvia Wassertheil-Smoller
• 金额: $ 58.56万
• 依托单位: ALBERT EINSTEIN COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-08-01 至 2008-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6935357
• 关键词: biomarker; blood coagulation; cell adhesion; cerebral ischemia /hypoxia; clinical research; disease /disorder proneness /risk; estrogens; female; glucose metabolism; hemostasis; high risk behavior /lifestyle; hormone therapy; human subject; hypertension; inflammation; lipid metabolism; patient oriented research; postmenopause; progestins; statistics /biometry; stroke; thrombosis; women' s health

DESCRIPTION: (provided by applicant) The Women's Health Initiative clinical trial of estrogen plus progestin for the prevention of cardiovascular disease in healthy, postmenopausal women, which was recently stopped due to adverse effects, as well as other secondary prevention clinical trials, have found increased risk of stroke in users of estrogen plus progestin. We wish to investigate possible mechanisms for such an increase by studying biomarkers of hemostasis /inflammation as risk factors for ischemic stroke and as mediators of stroke related effects of hormone replacement therapy and other risk factors, including hypertension and lifestyle variables. The goal of the proposed study is to determine whether blood-based biomarkers related to systemic inflammation, and/or atherothrombosis/hemostasis/coagulation may be important risk factors for ischemic stroke and subtypes of ischemic stroke among older women. We will conduct a population based nested case-control study of 1050 ischemic stroke cases and 1050 matched controls among participants in the Observational Study component of the Women's Health Initiative (WHI-OS). The WHI-OS, conducted in a multi-ethnic cohort in 40 centers throughout the United States, is a prospective study of 93,676 postmenopausal women, followed for 8 to 12 years, with extensive baseline and follow-up data including blood and DNA specimens collected and stored at baseline. Multivariate modeling techniques will be used to investigate the associations of selected biomarkers, hypertension, hormone use and lifestyle variables, with risk of ischemic stroke and specific stroke subtypes as classified by central adjudicators. We will also determine whether the effects on stroke risk of established risk factors (hypertension, smoking, diabetes) and use of specific medications (statins, aspirin, non-steroidal anti-inflammatory agents, estrogen and progesterone) will be modified in the presence of markers of inflammation and/or of atherothrombosis/hemostasis.

描述：（由申请人提供）妇女健康倡议的雌激素加孕激素用于预防健康绝经后妇女心血管疾病的临床试验最近因不良反应而停止，以及其他二级预防临床试验发现，雌激素加孕激素使用者中风的风险增加。我们希望通过研究止血/炎症的生物标志物作为缺血性中风的危险因素以及作为激素替代疗法和其他危险因素（包括高血压和生活方式变量）的中风相关效应的介质，来研究这种增加的可能机制。拟议研究的目的是确定与全身炎症和/或动脉粥样硬化血栓形成/止血/凝血相关的血液生物标志物是否可能是老年女性缺血性中风和缺血性中风亚型的重要危险因素。我们将对妇女健康倡议 (WHI-OS) 观察研究部分的参与者中的 1050 例缺血性中风病例和 1050 例匹配对照进行基于人群的巢式病例对照研究。 WHI-OS 在美国 40 个中心的多种族队列中进行，是一项对 93,676 名绝经后妇女进行的前瞻性研究，随访时间为 8 至 12 年，具有广泛的基线和随访数据，包括在基线时收集和存储的血液和 DNA 样本。多变量建模技术将用于研究选定的生物标志物、高血压、激素使用和生活方式变量与缺血性中风风险和中央裁判员分类的特定中风亚型的关联。我们还将确定已确定的危险因素（高血压、吸烟、糖尿病）和特定药物（他汀类药物、阿司匹林、非甾体类抗炎药、雌激素和黄体酮）的使用对中风风险的影响是否会在炎症和/或动脉粥样硬化血栓形成/止血标志物存在的情况下发生改变。

项目成果

Aspirin use, dose, and clinical outcomes in postmenopausal women with stable cardiovascular disease: the Women's Health Initiative Observational Study.

患有稳定心血管疾病的绝经后妇女的阿司匹林使用、剂量和临床结果：妇女健康倡议观察研究。

• DOI: 10.1161/circoutcomes.108.791269
• 发表时间: 2009
• 期刊: Circulation. Cardiovascular quality and outcomes
• 作者: Berger,JeffreyS;Brown,DavidL;Burke,GregoryL;Oberman,Albert;Kostis,JohnB;Langer,RobertD;Wong,NathanD;Wassertheil-Smoller,Sylvia
• 通讯作者: Wassertheil-Smoller,Sylvia

Inflammation and hemostasis biomarkers for predicting stroke in postmenopausal women: the Women's Health Initiative Observational Study.

• DOI: 10.1016/j.jstrokecerebrovasdis.2008.04.006
• 发表时间: 2008-11-01
• 期刊: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
• 作者: Kaplan, Robert C;McGinn, Aileen P;Wassertheil-Smoller, Sylvia
• 通讯作者: Wassertheil-Smoller, Sylvia