Am. Carter et al., Association of the alpha-fibrinogen Thr312Ala polymorphism with poststrokemortality in subjects with atrial fibrillation, CIRCULATION, 99(18), 1999, pp. 2423-2426
Citations number
13
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Background-The a-fibrinogen Thr312Ala polymorphism occurs in close proximit
y to several sites important for factor XIIIa-dependent cross-linking, whic
h raises the possibility that it affects fibrin clot stability.
Methods and Results-We determined the association of this polymorphism with
ischemic stroke, stroke subtype, and poststroke mortality. There was no si
gnificant difference in the genotype distributions of patients with acute i
schemic stroke (n=519) and healthy control subjects (n=423), nor was there
any association of this polymorphism with stroke subtype. In a Cox regressi
on model, a significant interaction between Thr312Ala and atrial fibrillati
on was identified in relation to poststroke mortality (P=0.002). In subject
s in sinus rhythm (n=418), there was no difference according to genotype in
the proportion of subjects who survived (approximate to 60% in each group)
, whereas in subjects with atrial fibrillation (n=101), there was decreased
survival in those possessing the A allele (TT=42.1%, TA=18%, AA=0%).
Conclusions-The Thr312Ala polymorphism may give rise to an increased suscep
tibility for embolization of intra-atrial clot, and these findings could ha
ve important implications for identifying subjects most at risk of developi
ng thromboembolic complications.