title: Hemostatic Markers and Long-Term Risk of Intracerebral Hemorrhage in Postmenopausal Women.
abstract: BACKGROUND
  Known risk factors for intracerebral hemorrhage (ICH) include age, hypertension, smoking, alcohol intake, and anticoagulant use. Some previous reports have indicated that hemostatic factors measured many years before the onset of ICH might predict the later occurrence of ICH. The objective of this analysis was to test whether selected hemostatic factors measured years before the onset of ICH could identify patients at higher risk for future ICH.
  
  
  METHODS
  We performed a nested case-control study within the Women's Health Initiative (WHI) cohort. Postmenopausal women aged 50-79 years (mean 68) at baseline (1993-1998) were enrolled at 40 Clinical Centers in the United States and followed for adjudicated ICH for a mean of 11.4 years. ICH cases (N = 75) and controls (N = 75) were matched on age, ethnicity, blood pressure, anticoagulant use, and treated hypertension. Stored blood samples from the baseline WHI examination were tested for von Willebrand factor (vWF), a disintegrin-like and metalloprotease domain with thrombospondin type-1 motif, number 13 (ADAMTS13), tissue plasminogen activator (t-PA), and urokinase plasminogen activator (u-PA). Platelet count, white blood cell count, and hemoglobin concentration were also measured.
  
  
  RESULTS
  Mean baseline levels of vWF (1.03 and .95 U/mL), ADAMTS13 (1.0 and 1.1 µg/mL), vWF : ADAMTS13 ratio (.99 and .92), t-PA (14.75 and 14.80 IU/mL), and u-PA (.09 and .10 IU/mL) were not significantly different by case-control status. Significant differences were also not identified for platelet count, hemoglobin, white blood count, or reported alcohol use.
  
  
  CONCLUSIONS
  None of the 4 baseline hemostatic factors nor the platelet count was predictive of future ICH risk in this long-term study of older postmenopausal women.
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, Illinois; Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Ju-Mi
authors.initials: JM
authors.lastname: Lee
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Juned
authors.initials: J
authors.lastname: Siddique
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, Illinois; Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hyeon Chang
authors.initials: HC
authors.lastname: Kim
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: David
authors.initials: D
authors.lastname: Green
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Linda
authors.initials: L
authors.lastname: Van Horn
authors.affiliation: UCSD School of Medicine, University of California, San Diego, California.
authors.forename: Matthew
authors.initials: M
authors.lastname: Allison
authors.affiliation: Albert Einstein College of Medicine, New York, New York.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Wassertheil-Smoller
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, Illinois. Electronic address: p-greenland@northwestern.edu.
authors.forename: Philip
authors.initials: P
authors.lastname: Greenland
mesh_terms: D000071120:ADAMTS13 Protein / Q000097:blood; D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002543:Cerebral Hemorrhage / Q000097:blood / Q000209:etiology*; D005260:Female; D006487:Hemostasis; D006801:Humans; D008875:Middle Aged; D010976:Platelet Count; D017698:Postmenopause; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000097:blood; D014481:United States; D014568:Urokinase-Type Plasminogen Activator / Q000097:blood; D014841:von Willebrand Factor / Q000032:analysis
chemical_list: D015415:Biomarkers; D014841:von Willebrand Factor; D010959:Tissue Plasminogen Activator; D014568:Urokinase-Type Plasminogen Activator; D000071120:ADAMTS13 Protein; C099604:ADAMTS13 protein, human
keywords: ADAMTS13; Cerebral hemorrhage; plasminogen activators; von Willebrand factor