Association of hemostatic variables with MRI-detected cerebral abnormalities: The atherosclerosis risk in communities study

Objectives: Population-based and clinical prospective studies have shown in dependent associations of several hemostatic factors with ischemic heart di sease and stroke. MRI-detected cerebral infarcts and white matter lesions a re often detected in elderly individuals without clinical disease. It has b een hypothesized that these types of lesions are often the consequence of c erebral ischemic damage and may be the precursors of clinical stroke. Metho ds: This study examined the relation between a range of hemostatic factors measured at baseline in middle-aged participants who were free of diagnosed cardiovascular disease in the Atherosclerosis Risk in Communities Study an d MRI-detected cerebral abnormalities at a 6-year follow-up examination. Re sults: Plasma fibrinogen and perhaps von Willebrand factor were associated positively, and protein C was associated negatively, with cerebral infarcti ons. Adjusted for other risk factors, the odds ratio for cerebral infarctio n was 1.21 (95% confidence interval, Cl = 1.02-1.44) per standard deviation increment for fibrinogen, 1.45 (95% CI = 0.97-1.37) per standard deviation increment for von Willebrand factor, and 0.77 (95% CI = 0.62-0.95) per sta ndard deviation increment for protein C. No hemostatic factor, however, was associated with white matter disease. Conclusions: This study has only a f ollow-up MRI, and it is likely that some MRI lesions were present at baseli ne. Nevertheless, increased levels of fibrinogen and von Willebrand factor and reduced levels of protein C appear to be associated with cerebral infar ction identified by MRI. Copyright (C) 2001 S. Karger AG. Basel.