Background and Purpose-Platelets play pivotal roles in the development of ischemic cerebrovascular disease (CVD).The platelet glycoprotein (GP) Ib/IX/V complex is a receptor for von Willebrand factor, which plays a major role in the initial phase of platelet activation under high shear stress conditions. This study was designed to investigate the association between a genetic variation of this receptor and the prevalence of CVD. Methods-Two hundred patients with ischemic CVD, as confirmed by brain CT and/or MRI, and 317 age-and sex-matched control subjects without clinical evidence of CVD or cardiovascular disease were analyzed for their genotype frequencies of the 145 Thr/Met dimorphism of the ␣-chain of GPIb (GPIb␣).
Results-Genotypes with145 Met (T/M and M/M) were more frequently found in the CVD patients (26.5%) than in control subjects (14.2%, Pϭ0.0005). The genotype effect was more obvious in those Ͻ60 years of age or without acquired cardiovascular risk factors. The odds ratio for nonsmoking women Ͻ60 years of age was 10.6 (95% confidence intervals, 2.2 to 51.7). Although the number of patients studied was small (nϭ24), transient ischemic attack showed the highest odds ratio (4.3, Pϭ0.0004), followed by lacunar infarction (ORϭ2.2, Pϭ0.0024) and atherothrombotic infarction (ORϭ1.5, Pϭ0.3143). Logistic regression analysis revealed that the presence of Met-allele was independently associated with CVD. Conclusions-Our study suggests that the platelet GPIb␣ genotype is a genetic risk factor for ischemic CVD.