title: Levels of alpha1-antitrypsin in plasma and risk of spontaneous cervical artery dissections: a case-control study.
abstract: OBJECTIVE
  Abnormalities of dermal connective tissue have been detected in patients with spontaneous cervical artery dissections (sCAD), suggesting an underlying structural defect of the arterial wall. Alpha1-antitrypsin (A1-AT) is a circulating serine proteinase inhibitor of proteolytic enzymes that helps to maintain the integrity of elastic and collagen fibers.
  
  
  METHODS
  To test the hypothesis that moderate deficiency of A1-AT may be a risk factor for sCAD, 22 cases with sCAD and 113 controls were included in the study.
  
  
  RESULTS
  Patients with sCAD had significantly mean lower levels of A1-AT compared with controls (116.0+/-24.9 versus 141.1+/-31.7 mg/dL; P<0.01). Low levels of A1-AT (<90 mg/dL) were more frequently observed in patients with sCAD compared with controls (27.3% versus 2.7%; P<0.001). A positive correlation between age and plasma levels of A1-AT was found (r=0.22; P<0.01). A1-AT levels were not affected by sex or vascular risk factors, including smoking habit. On multivariate analysis, A1-AT <90 mg/dL was associated with sCAD independently of age, sex, or vascular risk factors (odds ratio, 17.7; 95% confidence interval, 2.9 to 105.6).
  
  
  CONCLUSIONS
  Low plasma levels of A1-AT may be a risk factor for sCAD.
authors.affiliation: Neurology Service, University Hospital Germans Trías i Pujol, Carretera de Canyet, 08916, Badalona, Spain. nvila@ns.hugtip.scs.es
authors.forename: Nicolás
authors.initials: N
authors.lastname: Vila
authors.forename: Mónica
authors.initials: M
authors.lastname: Millán
authors.forename: Xavier
authors.initials: X
authors.lastname: Ferrer
authors.forename: Nadal
authors.initials: N
authors.lastname: Riutort
authors.forename: Domingo
authors.initials: D
authors.lastname: Escudero
mesh_terms: D000367:Age Factors; D000368:Aged; D000792:Angiography; D020215:Carotid Artery, Internal, Dissection / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D016022:Case-Control Studies; D015897:Comorbidity; D003710:Demography; D004198:Disease Susceptibility; D005260:Female; D006801:Humans; D016015:Logistic Models; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000453:epidemiology*; D014463:Ultrasonography; D020217:Vertebral Artery Dissection / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D000515:alpha 1-Antitrypsin / Q000032:analysis*
chemical_list: D000515:alpha 1-Antitrypsin