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 (动脉粥样硬化)被认为是导致缺血的潜在原因。 中风在老年人中。不同类型牙弓动脉粥样硬化的影响 种族-民族群体是未知的。此外，ARCH的联合 伴有脂质紊乱或高凝状态的动脉粥样硬化，可能会增强其 血栓潜力，还没有被研究过。一个以人口为基础的 建议进行病例对照研究，以解决以下具体目标：1) 确定主动脉弓动脉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-民族亚群中的重要性； 2)确定主动脉弓动脉粥样硬化是否与血脂有关 老年中风患者的异常或高凝状态。 次要目标将是评估4年内中风复发的风险 在整个组中有动脉粥样硬化和无动脉粥样硬化的患者 种族-民族亚群以及与以下方面相关的额外风险 动脉粥样硬化的形态特征(有溃疡或 移动组件)。 共300例缺血性中风患者和300例非中风对照组， 与年龄、性别和种族相匹配的学生将参加这一5年制课程 人群病例对照研究。研究对象将选自 正在进行的曼哈顿北部中风研究(NoMaSS)，这将确保 招聘和提供其他数据收集。ARCH的存在 动脉粥样硬化将通过经食道超声心动图确定。脂类 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高凝状态 检查将包括纤维蛋白原、凝血酶原片段F1+2和狼疮 抗凝剂。每年都会对个案进行电话跟进。 对照以确定死亡率和中风。条件Logistic回归 将用于计算调整后的主动脉弓卒中的优势比 总体研究组中的动脉粥样硬化，并按种族-民族分层 子组。本研究将为卒中病理生理学研究提供重要数据 并为临床试验评估治疗效果奠定了基础 治疗老年卒中和主动脉弓动脉粥样硬化的选择。

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.