PLATELET GLYCOPROTEIN RECEPTOR IIIA POLYMORPHISM P1A2 AND ISCHEMIC STROKE RISK - THE STROKE PREVENTION IN YOUNG-WOMEN STUDY

Background and Purpose-Platelet glycoprotein IIb/IIIa (GpIIb-IIIa), a membrane receptor for fibrinogen and von Willebrand factor, has been i mplicated in the pathogenesis of acute coronary syndromes but has not been previously investigated in relation to stroke in young adults. Me thods-We used a population-based case-control design to examine the as sociation of the GpIIIa polymorphism P1A2 with stroke in young women. Subjects were 65 cerebral infarction cases (18 patients with and 47 wi thout an identified probable etiology) 15 to 44 years of age from the Baltimore-Washington region and 122 controls frequency matched by age from the same geographic area. A face-to-face interview for vascular d isease risk factors and a blood sample for the P1A2 allele and serum c holesterol were obtained from each participant. Logistic regression wa s used to estimate the odds ratio for one or more P1A2 alleles after a djustment for other risk factors. Results-Among cases and controls, th e prevalence rates of one or more P1A2 alleles were 21% and 22% among blacks and 36% and 28% among whites, respectively. This genotype was s ignificantly associated with hypertension only in black control subjec ts but otherwise not with any of the established vascular risk factors . The adjusted odds ratio for cerebral infarction of one or more P1A2 alleles was 1.1 (confidence interval [CI], 0.6 to 2.3) overall, 0.5 (C I, 0.1 to 7.1) among blacks, and 1.4 (CI, 0.5 to 3.7) among whites. Fo r the cases with an identified probable etiology, the corresponding od ds ratios were 3.0 (CI, 0.9 to 10.4) overall, 0.7 (CI, 0.1 to 7.1) amo ng blacks, and 12.8 (CI, 1.2 to 135.0) among whites. Conclusions-No as sociation was found between the P1A2 polymorphism of GpIIIa and young women with stroke. However, subgroup analyses showed that the P1A2 pol ymorphism of GpIIIa appeared to be associated with stroke risk among w hite women, particularly those with a clinically identified probable e tiology for their stroke. Further work with an emphasis on stroke subt ypes and with multiracial populations is warranted.