title: Plasma fibrinogen concentrations and risk of stroke and its subtypes among Japanese men and women.
abstract: OBJECTIVE
  We aimed to examine the impact of fibrinogen concentrations on the incidence of stroke.
  
  
  METHODS
  We examined the association between fibrinogen and risk of total stroke and stroke subtypes in an 11-year prospective study of 4608 men and 7589 women aged 40 to 79 years with no history of stroke and/or coronary heart disease. The analysis was repeated, stratified by smoking status, to examine whether the association between fibrinogen and stroke was modified by smoking.
  
  
  RESULTS
  There were 317 incident total strokes comprising 103 hemorrhagic strokes (70 intraparenchymal hemorrhages [22.1% of strokes], 33 subarachnoid hemorrhages [10.4%]), 206 ischemic strokes (65.0%), and 8 strokes of undetermined type (2.5%). The multivariable hazard ratio (95% CI) for the highest versus lowest fibrinogen quartiles after adjustment for age, sex, area, and known cardiovascular risk factors was 2.5 (1.3 to 5.0), P<0.01, for hemorrhagic stroke and 3.2 (1.4 to 7.4), P<0.01, for intraparenchymal hemorrhage. There was no positive association of fibrinogen with risk of ischemic stroke or subarachnoid hemorrhage. Among never-smokers, the multivariable hazard ratio (95% CI) for the highest versus lowest fibrinogen quartiles was 3.5 (1.3 to 9.3), P=0.01, for hemorrhagic stroke and 4.4 (1.3 to 15.2), P=0.02, for intraparenchymal hemorrhage.
  
  
  CONCLUSIONS
  High plasma fibrinogen concentration can be a predictor for risk of intraparenchymal hemorrhage.
authors.affiliation: Osaka Medical Center for Health Science and Promotion, 1-3-2 Nakamichi, Higashinari-ku, Osaka 537-0025, Japan. xsato@kenkoukagaku.jp
authors.forename: Shinichi
authors.initials: S
authors.lastname: Sato
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Iso
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Noda
authors.forename: Akihiko
authors.initials: A
authors.lastname: Kitamura
authors.forename: Hironori
authors.initials: H
authors.lastname: Imano
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kiyama
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ohira
authors.forename: Takeo
authors.initials: T
authors.lastname: Okada
authors.forename: Masayuki
authors.initials: M
authors.lastname: Yao
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tanigawa
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Yamagishi
authors.forename: Masakazu
authors.initials: M
authors.lastname: Nakamura
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Naito
authors.forename: Takashi
authors.initials: T
authors.lastname: Shimamoto
mesh_terms: D000328:Adult; D000368:Aged; D002545:Brain Ischemia / Q000097:blood / Q000453:epidemiology; D002543:Cerebral Hemorrhage / Q000097:blood / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D015986:Confounding Factors, Epidemiologic; D005260:Female; D005340:Fibrinogen / Q000032:analysis*; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000097:blood / Q000453:epidemiology; D020521:Stroke / Q000097:blood* / Q000145:classification / Q000453:epidemiology; D013345:Subarachnoid Hemorrhage / Q000097:blood / Q000453:epidemiology
chemical_list: D005340:Fibrinogen