| Fibrinogen and the albumin-globulin ratio in recurrent stroke. | |
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MedLine Citation:
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PMID: 8342186 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND PURPOSE: In following patients initially recruited for a cross-sectional study of blood viscosity in ischemic cerebrovascular disease, it was noted that those having a low albumin-globulin ratio appeared to experience the majority of subsequent vascular events. Accordingly, a prospective study in which subjects were assigned to a high or low albumin-globulin cohort was undertaken to examine the relation between a low albumin-globulin ratio, the presence of clinical risk factors for stroke, and the occurrence of subsequent stroke, myocardial infarction, or vascular death. METHODS: Three groups of subjects were followed for an average of 1.5 +/- 0.8 years to ascertain vascular end points. Group 1 consisted of 126 patients with acute ischemic stroke; group 2 included 109 subjects matched with group 1 for age, medications, and recognized clinical risk factors for stroke; and group 3 was composed of 84 healthy volunteers, matched for age with groups 1 and 2. The median albumin-globulin ratio for group 1 at enrollment, 1.45, was used to dichotomize patients into two cohorts: all subjects with an albumin-globulin ratio of 1.45 or less were assigned to the "low" albumin-globulin cohort; those whose ratio was greater than 1.45 were assigned to the "high" albumin-globulin cohort. The occurrence of vascular end points was verified during subsequent hospitalizations and outpatient clinic visits and by telephone interviews of patients and providers. RESULTS: A total of 51 vascular events occurred, including 39 in group 1, 8 in group 2, and 4 in group 3. Subjects in either group 1 or 2 who were in the low albumin-globulin cohort had at least double the risk for a subsequent vascular event compared with their counterparts in the high albumin-globulin cohort (P < .01 and P < .03, respectively). In comparison with the high albumin-globulin cohort, significantly more patients in the low albumin-globulin cohort in group 1 had a history of prior stroke (P < .03). When groups 1 and 2 were combined, both a low albumin-globulin ratio and diabetes had a significant independent association with increased risk for subsequent vascular events in a Cox proportional-hazards model (P < .01 and P < .03, respectively). CONCLUSIONS: The results of this study indicate that significantly increased risk for subsequent vascular events in stroke patients and in subjects with clinical risk factors for stroke is associated with a shift in the concentrations of blood proteins to a prothrombotic environment characterized by lower levels of albumin and an increased concentration of globulins and fibrinogen. |
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Authors:
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N Beamer; B M Coull; G Sexton; P de Garmo; R Knox; G Seaman |
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Publication Detail:
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Type: Journal Article; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Stroke; a journal of cerebral circulation Volume: 24 ISSN: 0039-2499 ISO Abbreviation: Stroke Publication Date: 1993 Aug |
Date Detail:
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Created Date: 1993-08-31 Completed Date: 1993-08-31 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0235266 Medline TA: Stroke Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1133-9 Citation Subset: IM |
Affiliation:
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Oregon Health Sciences University, Portland. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cerebrovascular Disorders / blood* Cohort Studies Female Fibrinogen / analysis* Humans Male Middle Aged Myocardial Infarction / etiology Prospective Studies Recurrence Risk Factors Serum Albumin / analysis* Serum Globulins / analysis* Vascular Diseases / etiology, mortality |
| Grant Support | |
ID/Acronym/Agency:
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NS-17493/NS/NINDS NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Serum Albumin; 0/Serum Globulins; 9001-32-5/Fibrinogen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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