Back to Search
Start Over
Ethnic differences in markers of thrombophilia: implications for the investigation of ischemic stroke in multiethnic populations: the South London Ethnicity and Stroke Study.
- Source :
-
Stroke [Stroke] 2003 Aug; Vol. 34 (8), pp. 1821-6. Date of Electronic Publication: 2003 Jul 03. - Publication Year :
- 2003
-
Abstract
- Background and Purpose: The role of hypercoagulable states in the pathogenesis of ischemic stroke in black subjects is not known, and data on normal reference ranges in black populations are lacking. This study estimated ethnic-specific reference ranges in a community population to determine the prevalence of thrombophilic states in a multiethnic stroke population.<br />Methods: Free protein S, protein C, antithrombin III, activated protein C resistance, IgG anticardiolipin antibodies, and lupus anticoagulant were determined in 130 consecutive ischemic stroke cases < or =65 years of age (50 black Caribbeans, 30 black Africans, 50 whites) and 130 community controls.<br />Results: Black African controls had significantly lower protein S (P<0.001) and protein C (P=0.049) and a trend toward lower antithrombin III (P=0.056) levels compared with white controls. Black Caribbean and African controls had higher diluted Russell's viper venom time ratios compared with whites (P=0.001, P<0.001). Using ethnic-specific reference ranges, 8 controls (6.3%) and 11 cases (8.5%) had thrombophilia abnormalities (odds ratio [OR], 1.39; 95% confidence interval [CI], 0.54 to 3.57; P=0.50). ORs were 0.96 (95% CI, 0.18 to 4.99; P=0.96) for whites, 1.57 (95% CI, 0.41 to 5.94; P=0.51) for black Caribbeans, and 2.07 (95% CI, 0.18 to 24.2; P=0.95) for black Africans.<br />Conclusions: Failure to account for ethnic differences in the normal reference ranges for thrombophilia markers may lead to inappropriate diagnosis and investigation of hypercoagulable states in black individuals. Protein S and protein C deficiencies and lupus anticoagulant may contribute to stroke risk in a minority of black cases, but they are unlikely to be major contributors to the excess stroke risk seen in young individuals of African and African-Caribbean descent.
- Subjects :
- Africa ethnology
Biomarkers blood
Black People
Caribbean Region ethnology
Comorbidity
Female
Humans
London epidemiology
Lupus Coagulation Inhibitor blood
Male
Middle Aged
Odds Ratio
Prevalence
Protein C analysis
Protein S analysis
Reference Values
Risk Assessment
Risk Factors
Stroke blood
Stroke epidemiology
Thrombophilia blood
Thrombophilia epidemiology
White People
Stroke ethnology
Thrombophilia diagnosis
Thrombophilia ethnology
Subjects
Details
- Language :
- English
- ISSN :
- 1524-4628
- Volume :
- 34
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Stroke
- Publication Type :
- Academic Journal
- Accession number :
- 12843341
- Full Text :
- https://doi.org/10.1161/01.STR.0000083049.65008.5F