Prospective study of markers of hemostatic function with risk of ischemic stroke

Background-Several markers of hemostatic function and inflammation have bee n associated with increased risk of coronary heart disease, but prospective evidence for their role in ischemic stroke is scant. Methods and Results-The Atherosclerosis Risk in Communities (ARIC) Study me asured several of these markers in more than 14 700 participants 45 to 64 y ears old who were free of cardiovascular disease and were followed up for 6 to 9 years for occurrence of ischemic stroke (n=191), There was no apparen t association between ischemic stroke incidence and factor VIIc, antithromb in III. platelet count, or activated partial thromboplastin time. After adj ustment for multiple cardiovascular risk factors, von Willebrand factor, fa ctor VIIIc, fibrinogen, and white blood cell count were positively associat ed and protein C was negatively but nonsignificantly associated with ischem ic stroke incidence in regression analyses based on either continuous varia bles or fourths of the variable distributions. The adjusted relative risk l and 95% CI) for ischemic stroke in those in the highest versus lowest fourt h were: von Willebrand factor, 1.71 (1.1 to 2.7); factor VIIIc, 1.93 (1.2 t o 3.1); white blood cell count, 1.50 (0.9 to 2.4), fibrinogen. 1.26 (0.8 to 2.0); and protein C, 0.65 (0.4 to 1.0), Conclusions-This study offers modest support for the hypothesis that some m arkers of hemostatic function and inflammation can identify groups of middl e-aged adults at increased risk of stroke. These factors may play a role in the pathogenesis of ischemic stroke.