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A Method for Screening and Validation of Resistant Mutations Against Kinase Inhibitors
Published on: December 7, 2014
JAK2V617F mutation is highly prevalent in patients with ischemic stroke: a case-control study
Marie Hvelplund Kristiansen1,2, Lasse Kjær3, Vibe Skov3
1Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Insights
The JAK2V617F gene mutation is more prevalent in ischemic stroke patients than in the general population, suggesting it as a new cerebrovascular risk factor. This association is particularly strong in current smokers.
Area of Science:
- Genetics
- Neurology
- Cardiology
Background:
- Ischemic stroke has a high recurrence rate, necessitating the identification of novel risk factors.
- The JAK2V617F gene mutation, present in 3.1% of the general population, is a potential, yet understudied, cerebrovascular risk factor.
Purpose of the Study:
- To investigate the prevalence of the JAK2V617F mutation in Danish ischemic stroke patients compared to matched controls.
- To determine if JAK2V617F mutation is an independent risk factor for ischemic cerebrovascular disease (ICVD).
Main Methods:
- A cohort of 538 consecutive Danish ischemic stroke patients (within 7 days of symptom onset) was compared with age- and sex-matched controls from the Danish General Suburban Population Study.
- Droplet digital polymerase chain reaction (ddPCR) was used to analyze DNA for the JAK2V617F mutation in both patients and controls.
- Multiple-adjusted conditional logistic regression analysis was employed to assess the association between JAK2V617F and ICVD, adjusting for cerebrovascular comorbidities.
Main Results:
- The JAK2V617F mutation was identified in 11.3% of ischemic stroke patients, compared to 4.4% in matched controls.
- Patients with ischemic stroke had a 2.37-fold increased likelihood of carrying the JAK2V617F mutation (OR, 2.37; 95% CI, 1.57-3.58; P < .001) after adjusting for risk factors.
- The association between JAK2V617F and ischemic stroke was significantly stronger in current smokers (OR, 4.78; 95% CI, 2.22-10.28; P < .001).
Conclusions:
- The JAK2V617F mutation is a novel and significant risk factor for ischemic stroke.
- Identifying and managing JAK2V617F may offer new therapeutic strategies for stroke prevention, particularly in smokers.
Abstract:
Ischemic stroke has a high recurrence rate despite treatment. This underlines the significance of investigating new possible cerebrovascular risk factors, such as the acquired gene mutation JAK2V617F found in 3.1% of the general population. We aimed to investigate the prevalence of the JAK2V617F mutation in a population with ischemic stroke compared with that in matched controls. We enrolled 538 consecutive Danish patients with ischemic stroke (mean age, 69.5 ± 10.9 years; 39.2% female) within 7 days of symptom onset. Using multiple-adjusted conditional logistic regression analysis, we compared the prevalence of JAK2V617F with that in age- and sex-matched controls free of ischemic cerebrovascular disease (ICVD) from the Danish General Suburban Population Study. DNA was analyzed for JAK2V617F mutation using sensitive droplet digital polymerase chain reaction in patients and controls. Of the 538 patients with ischemic stroke, 61 (11.3%) had JAK2V617F mutation. There were no differences in patient demographics or cerebrovascular comorbidities between the patients with and without mutations. Patients with ischemic stroke were more likely to have the JAK2V617F mutation than matched controls, in whom the JAK2V617F prevalence was 4.4% (odds ratio, 2.37; 95% confidence interval, 1.57-3.58; P < .001). A subanalysis stratified by smoking history revealed that the association was strongest in current smokers (odds ratio, 4.78; 95% confidence interval, 2.22-10.28; P < .001). Patients with ischemic stroke were 2.4 times more likely to have the JAK2V617F mutation than matched controls without ICVD when adjusting for other cerebrovascular risk factors. This finding supports JAK2V617F mutation as a novel cerebrovascular risk factor.
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