Plasma fibrinogen concentrations and risk of stroke and its subtypes among Japanese men and women.
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.
Sato
Shinichi
S
Osaka Medical Center for Health Science and Promotion, 1-3-2 Nakamichi, Higashinari-ku, Osaka 537-0025, Japan. xsato@kenkoukagaku.jp
Iso
Hiroyasu
H
Noda
Hiroyuki
H
Kitamura
Akihiko
A
Imano
Hironori
H
Kiyama
Masahiko
M
Ohira
Tetsuya
T
Okada
Takeo
T
Yao
Masayuki
M
Tanigawa
Takeshi
T
Yamagishi
Kazumasa
K
Nakamura
Masakazu
M
Naito
Yoshihiko
Y
Shimamoto
Takashi
T
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
D005340:Fibrinogen