Résumé
Background@#and Purpose The association of dyslipidemia with stroke has been inconsistent, which may be due to differing associations within etiological stroke subtypes. We sought to determine the association of lipoproteins and apolipoproteins within stroke subtypes. @*Methods@#Standardized incident case-control STROKE study in 32 countries. Cases were patients with acute hospitalized first stroke, and matched by age, sex and site to controls. Concentrations of total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (apoA1), and apoB were measured. Non-HDL-C was calculated. We estimated multivariable odds ratio (OR) and population attributable risk percentage (PAR%). Outcome measures were all stroke, ischemic stroke (and subtypes), and intracerebral hemorrhage (ICH). @*Results@#Our analysis included 11,898 matched case-control pairs; 77.3% with ischemic stroke and 22.7% with ICH. Increasing apoB (OR, 1.10; 95% confidence interval [CI], 1.06 to 1.14 per standard deviation [SD]) and LDL-C (OR, 1.06; 95% CI, 1.02 to 1.10 per SD) were associated with an increase in risk of ischemic stroke, but a reduced risk of ICH. Increased apoB was significantly associated with large vessel stroke (PAR 13.4%; 95% CI, 5.6 to 28.4) and stroke of undetermined cause. Higher HDL-C (OR, 0.75; 95% CI, 0.72 to 0.78 per SD) and apoA1 (OR, 0.63; 95% CI, 0.61 to 0.66 per SD) were associated with ischemic stroke (and subtypes). While increasing HDL-C was associated with an increased risk of ICH (OR, 1.20; 95% CI, 1.14 to 1.27 per SD), apoA1 was associated with a reduced risk (OR, 0.80; 95% CI, 0.75 to 0.85 per SD). ApoB/A1 (OR, 1.38; 95% CI, 1.32 to 1.44 per SD) had a stronger magnitude of association than the ratio of LDL-C/HDL-C (OR, 1.26; 95% CI, 1.21 to 1.31 per SD) with ischemic stroke (P<0.0001). @*Conclusions@#The pattern and magnitude of association of lipoproteins and apolipoproteins with stroke varies by etiological stroke subtype. While the directions of association for LDL, HDL, and apoB were opposing for ischemic stroke and ICH, apoA1 was associated with a reduction in both ischemic stroke and ICH. The ratio of apoB/A1 was the best lipid predictor of ischemic stroke risk.
Résumé
To investigate the possible association between the codon 72 polymorphism [Pro72Arg, rsl 042522] of the tumor suppressor gene [TP53] and the presence of coronary artery disease [CAD] in Chilean A total of 209 unrelated patients with a diagnosis of CAD confirmed by angiography [33-74 years old] and 216 healthy controls [30-68 years old] were included in this study. The Pro72Arg polymorphism of the TP53 gene was evaluated by PCR-RFLP. The genotype distribution for the Pro72Arg variant of the TP53 gene in CAD patients [PP: n = 13, 6.2%; PR: n - 61, 29.4%; RR: n - 135, 64.6%] and controls [PP: n = 18, 8.3%; PR: n = 94, 43.5%; RR: n - 104, 48.1%] was significantly different [p = 0.003]. Similarly, the allelic frequency was also different [p = 0.003]. The odds ratio for CAD related to the 72Arg allele was 2.0 [95% Cl = 1.33-2.90], confirming the presence of an association. These findings suggest that the Pro72Arg polymorphism of the TP53 gene is associated with CAD in Chilean individuals