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Updated: Mar 28, 2026

A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
Shared genetic susceptibility of vascular-related biomarkers with ischemic and recurrent stroke
Stephen R Williams1, Fang-Chi Hsu1, Keith L Keene1
1From the Center for Public Health Genomics (S.R.W., K.L.K., W.-M.C., S.S.R., M.M.S.), Cardiovascular Research Center (S.R.W.), and Departments of Public Health Sciences (A.M.S., B.B.W.), Neurology (P.M., B.B.W.), Medicine (M.M.S.), Biochemistry and Molecular Genetics (M.M.S.), and Public Health Sciences (S.S.R.), University of Virginia, Charlottesville; Department of Biostatistical Sciences (F.-C.H.), Wake Forest School of Medicine, Winston-Salem, NC; National Human Genome Research Institute (E.B.M.), Bethesda, MD; Departments of Neurology (A.M.S., K.L.F.) and Neuroscience (K.L.F.), Brown University, Providence, RI; Department of Neurology (B.C.), University of Arizona, Tucson; Department of Biology (K.L.K.) and Center for Health Disparities (K.L.K.), East Carolina University, Greenville, NC; Department of Biostatistics (S.N., S.M.G.), University of Washington, Seattle; Department of Clinical Laboratory Sciences (G.D.), University of Cape Town, South Africa; Department of Biochemistry (J.L.R.), University of Missouri, Columbia; Institute for Stroke and Dementia Research (R.M.), Klinikum der Universität München, Ludwig-Maximilians-Universität München, Munich, Germany; Department of Biostatistics (J.D.), Boston University School of Public Health; and Departments of Neurology (S.S.) and Medicine (H.L.), Boston University School of Medicine, MA.
Insights
Genetic variations influence inflammatory and hemostatic biomarkers, impacting ischemic stroke risk. These findings enhance understanding of genetic contributions to stroke and biomarker variation for clinical evaluation.
Area of Science:
- Genetics
- Neurology
- Biochemistry
Background:
- Cerebrovascular disease and ischemic stroke have complex etiologies.
- Biomarkers like C-reactive protein (CRP) and fibrinogen play roles in stroke pathogenesis.
- Understanding genetic influences on these biomarkers is crucial for risk assessment.
Purpose of the Study:
- To investigate genetic factors contributing to cerebrovascular disease.
- To explore genetic variations in biomarkers associated with ischemic stroke.
- To identify genetic links between biomarker levels and stroke risk.
Main Methods:
- Genome-wide association scans (GWAS) were performed on biomarkers from the Vitamin Intervention for Stroke Prevention Trial (VISP).
- Key biomarkers included C-reactive protein (CRP), fibrinogen, and others.
- Replication analyses were conducted to validate findings.
Main Results:
- Significant associations were found between CRP single nucleotide polymorphisms (SNPs) and circulating CRP levels.
- A novel association of CRP levels with the AKR1D1 locus was identified.
- CRP-associated SNPs and CRP levels correlated with ischemic and recurrent stroke risk.
- Fibrinogen levels, but not associated SNPs, were linked to recurrent stroke risk.
Conclusions:
- Genetic factors contribute to inflammatory and hemostatic biomarker variation in stroke patients.
- Shared genetic influences exist between CRP levels and ischemic stroke risk.
- These findings improve understanding of genetic contributors to biomarker variation and stroke risk, aiding clinical evaluation.
Objective:
To investigate the genetic contributors to cerebrovascular disease and variation in biomarkers of ischemic stroke.
Methods:
The Vitamin Intervention for Stroke Prevention Trial (VISP) was a randomized, controlled clinical trial of B vitamin supplementation to prevent recurrent stroke, myocardial infarction, or death. VISP collected baseline measures of C-reactive protein (CRP), fibrinogen, creatinine, prothrombin fragments F1+2, thrombin-antithrombin complex, and thrombomodulin prior to treatment initiation. Genome-wide association scans were conducted for these traits and follow-up replication analyses were performed.
Results:
We detected an association between CRP single nucleotide polymorphisms (SNPs) and circulating CRP levels (most associated SNP, rs2592902, p = 1.14 × 10(-9)) in 2,100 VISP participants. We discovered a novel association for CRP level in the AKR1D1 locus (rs2589998, p = 7.3 × 10(-8), approaching genome-wide significance) that also is an expression quantitative trait locus for CRP gene expression. We replicated previously identified associations of fibrinogen with SNPs in the FGB and LEPR loci. CRP-associated SNPs and CRP levels were significantly associated with risk of ischemic stroke and recurrent stroke in VISP as well as specific stroke subtypes in METASTROKE. Fibrinogen levels but not fibrinogen-associated SNPs were also found to be associated with recurrent stroke in VISP.
Conclusions:
Our data identify a genetic contribution to inflammatory and hemostatic biomarkers in a stroke population. Additionally, our results suggest shared genetic contributions to circulating CRP levels measured poststroke and risk for incident and recurrent ischemic stroke. These data broaden our understanding of genetic contributors to biomarker variation and ischemic stroke risk, which should be useful in clinical risk evaluation.
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