Regional & Racial Differences in Hemostasis & Risk of Stroke & Heart Disease

描述（由申请人提供）：我们为Neil a . Zakai博士（佛蒙特大学的初级教员）提出了一个为期5年的研究和培训计划，通过调查30,228名黑人和白人的止血生物标志物水平对中风和冠心病（CHD）的区域和种族差异的影响，来发展血管流行病学方面的独立职业生涯。国际公认的心血管流行病学研究者Mary Cushman博士将担任本项目的主要导师。在本研究期间，库什曼博士将支持该项目的教育和研究方面。咨询委员会由流行病学、神经病学和血液学专家选出，为建立网络和未来合作提供最佳机会。扎井博士将每月亲自或通过电话会议与咨询委员会会面。为了让扎井博士在未来有一个独立的研究生涯，我们建议他在佛蒙特大学和约翰霍普金斯大学彭博公共卫生学院学习流行病学和生物统计学的具体课程。该项目将是一项病例队列研究，重点研究多种止血生物标志物（包括个体和群体）对美国中风和冠心病发病率的地区和种族差异的影响。具体目标是1)在REGARDS中创建嵌套病例队列研究，2)使用多变量建模和因素分析来阐明卒中和冠心病的机制，3)将止血生物标志物和传统心血管疾病危险因素整合到卒中和冠心病风险模型中，该模型可以解释心血管疾病的种族和/或地区差异。佛蒙特大学的临床和生化研究实验室是开展这项研究的理想场所，它将实验室方面和流行病学专业知识结合在一起，确保了丰富的转化研究经验。

DESCRIPTION (provided by applicant): We propose a 5-year research and training program for Dr. Neil A. Zakai (a junior faculty member at the University of Vermont) to develop an independent career in vascular epidemiology by investigating the impact hemostatic biomarker levels have on regional and racial differences in stroke and coronary heart disease (CHD) in the 30,228 black and white individuals in the REasons for Geographic and Racial Differences in Stroke study (REGARDS). Dr. Mary Cushman, an internationally recognized investigator in cardiovascular epidemiology, will serve as the principle mentor for this project. Though the period of this study, Dr. Cushman will support the educational and research aspects of this project. The advisory committee was selected from experts in epidemiology, neurology, and hematology to provide the best opportunities for networking and future collaborations. Dr. Zakai will meet with the advisory committee both in person and through teleconferences on a monthly basis. To achieve a future independent research career for Dr. Zakai, we propose specific coursework in epidemiology and biostatistics at the University of Vermont and the Johns Hopkins Bloomberg School of Public Health. The project will be a case-cohort study focusing on the impact of multiple hemostatic biomarkers (both individually and in groups) on the regional and racial differences in stroke and CHD incidence in the United States. The specific aims will 1) create the nested case-cohort study within REGARDS, 2) use multivariable modeling and factor analysis to elucidate mechanisms for stroke and CHD and 3) integrate hemostatic biomarkers and traditional CVD risk factors into a model for stroke and CHD risk that can account for racial and/or regional differences in CVD. The Laboratory for Clinical and Biochemical Research at the University of Vermont serves as an ideal setting to conduct this research by bringing together the laboratory aspects and the epidemiological expertise to ensure a rich translational research experience. PUBLIC HEALTH RELEVANCE: There are regional and racial differences in coronary heart disease and stroke not explained by conventional cardiovascular risk factors. We hypothesize that regional and racial differences in hemostasis underlie some of these disparities.