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Biomarkers and functional outcomes from ischaemic cerebral events in women: a prospective cohort study
P M Rist1, J E Buring, C S Kase
1Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA. prist@partners.org
Insights
High total cholesterol increases the risk of poor functional outcomes after stroke. Associations between other cardiovascular biomarkers and stroke functional outcomes were inconsistent in women.
Area of Science:
- Cardiovascular disease epidemiology
- Neurology
- Biomarker research
Background:
- Numerous biomarkers are linked to increased ischemic stroke risk.
- The relationship between these biomarkers and functional recovery post-stroke remains unclear.
Purpose of the Study:
- To investigate the association between cardiovascular disease biomarkers and functional outcomes following ischemic cerebral events in women.
Main Methods:
- A prospective cohort study of 27,728 women from the Women's Health Study.
- Analysis of blood samples and functional outcomes (modified Rankin Scale scores) after transient ischemic attack (TIA) and ischemic stroke using multinomial logistic regression.
Main Results:
- Over 15.1 years, 461 TIAs and 380 strokes occurred.
- Elevated total cholesterol showed the highest risk for poor functional outcome (mRS 4-6).
- Associations were found between total cholesterol, Lp(a), C-reactive protein, triglycerides, and mild/moderate functional outcomes.
Conclusions:
- Total cholesterol is associated with the highest risk of poor functional outcomes post-stroke.
- The overall pattern of association between vascular biomarkers and stroke functional outcomes was inconsistent.
Background And Purpose:
Several biomarkers have been associated with an increased risk of ischaemic stroke. However, the association between these biomarkers and functional outcome from cerebral ischaemic events is unclear. We aimed to assess the patterns of association between cardiovascular disease biomarkers and functional outcomes after incident ischaemic cerebral events in women.
Methods:
Prospective cohort study of 27,728 women enrolled in the Women's Health Study who provided information on blood samples and were free of stroke or transient ischaemic attack (TIA) at baseline. Multinomial logistic regression was used to determine the association between elevated biomarker levels and functional outcomes from ischaemic cerebral events. Possible functional outcomes included TIA and ischaemic stroke with modified Rankin Scale (mRS) score of 0-1, 2-3, or 4-6.
Results:
After a mean follow-up of 15.1 years, 461 TIAs and 380 ischaemic strokes occurred. Elevated levels of total cholesterol were associated with the highest risk of poor functional outcome (mRS 4-6) after incident cerebral ischaemic events (relative risk = 2.02, 95% CI = 1.18-3.46). We observed significant associations between elevated levels of total cholesterol, Lp(a), C-reactive protein, and triglycerides, and mild or moderate functional outcomes after ischaemic cerebral events. Elevations in all other biomarkers were not significantly associated with functional outcomes.
Conclusions:
Whilst total cholesterol level was associated with highest risks of poor functional outcome after stroke, we overall observed an inconsistent pattern of association between biomarkers linked with an increased risk of vascular events and more impaired functional outcomes from stroke.
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