title: Prospective study on soluble thrombomodulin and von Willebrand factor and the risk of ischemic and hemorrhagic stroke.
abstract: The aim of the present study was to examine if soluble thrombomodulin (sTM) and von Willebrand factor (VWF) could predict a first-ever ischemic or hemorrhagic stroke. This study was an incident case-referent study from within a population-based cohort in northern Sweden. Up to 1996 about 44,000 subjects had been screened and stroke cases were classified according to the WHO MONICA criteria. A first-ever stroke occurred in 108 cases. A total of 216 controls were selected from the same cohort. This prospective study found no association with sTM or VWF and the development of a first-ever ischemic stroke (n = 87) in the logistic regression model. For the hemorrhagic stroke cases (n = 18), the multivariate logistic regression model revealed a significant negative association with sTM. When dichotomized, the upper level (>17.3 microg/L) of sTM, as compared with the lower level (<17.3 microg/L), showed one fifth of the risk for hemorrhagic stroke (OR, 0.18; CI, 0.05 to 0.69). No significant association was found for VWF. We suggest that the novel finding of an inverse relation between sTM and hemorrhagic stroke should be investigated in a larger study.
authors.affiliation: Department of Medicine, Skellefteå County Hospital, Skellefteå, Sweden. lars.johansson.ss@vll.se
authors.forename: Lars
authors.initials: L
authors.lastname: Johansson
authors.forename: Jan-Håkan
authors.initials: JH
authors.lastname: Jansson
authors.forename: Kurt
authors.initials: K
authors.lastname: Boman
authors.forename: Torbjörn K
authors.initials: TK
authors.lastname: Nilsson
authors.forename: Birgitta
authors.initials: B
authors.lastname: Stegmayr
authors.forename: Göran
authors.initials: G
authors.lastname: Hallmans
mesh_terms: D002545:Brain Ischemia / Q000097:blood / Q000453:epidemiology*; D002543:Cerebral Hemorrhage / Q000097:blood / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012306:Risk; D012995:Solubility; D013548:Sweden / Q000453:epidemiology; D018180:Thrombomodulin / Q000032:analysis*; D014841:von Willebrand Factor / Q000032:analysis*
chemical_list: D018180:Thrombomodulin; D014841:von Willebrand Factor