Serum Ferritin Is a Risk Factor for Stroke in Postmenopausal Women

Der, Daphne L. Van; Grobbee, Diederick E.; Roest, Mark; Marx, Joannes J.M.; Voorbij, H. A. M.; Schouw, Yvonne T. van der

doi:10.1161/01.str.0000173172.82880.72

Cited by 85 publications

(63 citation statements)

References 30 publications

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“…It is well known that genetic polymorphisms in the warfarinsensitive protein vitamin K epoxide reductase complex subunit 1 (VKORC1) modulate sensitivity to warfarin. Recently, five different heterozygous missense mutations have been found in patients suffering from warfarin resistance [2][3][4].…”

Section: Disclosure Of Conflict Of Interestsmentioning

confidence: 99%

Risk of acute ischemic heart disease in postmenopausal women depends on von Willebrand factor and fibrinogen concentrations, and blood group genotype

Roest

Voorbij

Barendrecht

et al. 2007

Journal of Thrombosis and Haemostasis

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plotted on the y-axis and the PTRs using the local laboratory reagent are plotted on the x-axis, the slope of the line is known as the International Sensitivity Index (ISI). The INR is then the PTR found in the local laboratory raised to the power of the ISI.This system has improved anticoagulant control worldwide. However, it is important to realize that the straight-line relationship described above is only valid for patients stably anticoagulated with VKA, and therefore this manipulation of the PTR to the INR is only valid for these patients and not for patients with other coagulation defects. For example, the INR system is not valid for comparison of patients with liver impairment because different reagents do not give the same INR for the same sample [2]. The Haemostasis and Thrombosis Task Force of the British Committee for Standards in Haematology has noted that many UK laboratories now report all their PTs as INRs. We wish to discourage this practice, and for patients who are not on VKA, we prefer either the PT in seconds or the PTR, in both cases with a 95% reference range for comparison. In most cases, it is prolonged results that are of interest, so it would also be acceptable to report the result with the reference being given as less than the upper limit of the 95% reference range. We accept that if both the result and the local reference range are converted to an INR, then no information is lost; however, a spurious improvement is implied and we suggest that this should be avoided. Converting the result to an INR without providing a local reference range also converted to an INR is unhelpful. Disclosure of Conflict of InterestsThe author states that he has no conflict of interest. Risk of acute ischemic heart disease in postmenopausal women depends on von Willebrand factor and fibrinogen concentrations, and blood group genotype Acute ischemic heart disease (IHD) is the major cause of death in developed countries. A crucial step in the development of acute IHD is platelet aggregate formation at the site of a ruptured atherosclerotic plaque [1]. The sensitivity for platelet aggregate formation depends on genetic variation in platelet glycoproteins (a 2 b 1 , GPIb, a IIb b 3 and GPVI) and on the availability of von Willebrand factor (VWF) and fibrinogen (reviewed in Ruggeri [2]). Furthermore, genetic coagulation markers -factor (F)V 1691GA and FII 20210GA -may be involved in the development of acute IHD. It is our hypothesis that subjects with high sensitivity to platelet aggregation (blood group A or B genotype, a 2 b 1 807T, GPIb -5T, a IIb b 3 Pl A2 , GPVI -13254T, high VWF levels and/or high fibrinogen levels) and high sensitivity to coagulation (FV 1691A and FII 20210A) are more prone to develop acute IHD than subjects who are less sensitive to platelet aggregation (blood group 0 genotype, a 2 b 1 C807, GPIb C-5, a IIb b 3 Pl A1 , GPVI -13254C, low VWF levels and/or low fibrinogen levels) and coagulation (FV G1691 and FII G20210).Until now, research on the contribution of platelet procoagulant ...

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Section: Disclosure Of Conflict Of Interestsmentioning

confidence: 99%

Risk of acute ischemic heart disease in postmenopausal women depends on von Willebrand factor and fibrinogen concentrations, and blood group genotype

Roest

Voorbij

Barendrecht

et al. 2007

Journal of Thrombosis and Haemostasis

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“…In one study, an increased risk of ischemic stroke for the highest versus lowest tertile of ferritin in postmenopausal women was seen [8]. In the second study, a reduced risk of stroke was found for the middle tertile of serum iron concentrations [9].…”

Section: Introductionmentioning

confidence: 99%

Iron Stores and HFE Genotypes Are Not Related to Increased Risk of Ischemic Stroke

Ekblom

Hultdin²,

Stegmayr³

et al. 2007

Cerebrovasc Dis

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Background: High iron levels can increase the formation of noxious oxygen radicals, which are thought to contribute to cerebrovascular disease. The aim of this prospective study was to determine if iron status and HFE genotypes constitute risk factors for stroke. Methods: First-ever stroke cases (231 ischemic and 42 hemorrhagic) and matched double referents from the population-based Northern Sweden cohorts were studied in a nested case-referent setting. Results: For total iron binding capacity, an increased risk of ischemic stroke was seen in the highest quartile (OR 1.80; 95% CI 1.14–2.83; p for trend 0.012). The highest quartile of transferrin iron saturation showed a decreased risk of ischemic stroke in men (OR 0.44; 95% CI 0.22–0.87; p for trend 0.028), but not in women. There was an increased risk of hemorrhagic stroke in the second (OR 4.07; 95% CI 1.09–15.20) and third quartile (OR 4.22; 95% CI 1.08–16.42) of ferritin. Neither quartiles of plasma iron concentrations nor the HFE C282Y and H63D genotypes were associated with ischemic or hemorrhagic stroke. Conclusions: Iron stores were not positively related to increased risk of ischemic stroke. Furthermore, HFE genotypes did not influence the risk of ischemic or hemorrhagic stroke.

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“…21 In one prospective study, there was a statistically significant inverse association between total iron intake and risk of ischemic stroke, 23 but not in other. 22 There are also a few prospective studies [32][33][34] and studies of stroke patients [35][36][37] relating iron status in blood to risk of stroke. Most of those studies, 32,33,[35][36][37] but not all, 34 indicate a positive association between serum ferritin levels and risk of stroke.…”

Section: Discussionmentioning

confidence: 99%

Heme Iron Intake and Risk of Stroke

Kałuża

Wolk

Larsson

2013

Stroke

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Background and Purpose-Intake of iron, especially heme iron, has been associated with several diseases. However, epidemiological studies of heme iron and nonheme iron intake in relation to risk of stroke are lacking. The aim of this study was to examine the associations between heme iron and nonheme iron intake and stroke incidence in men. Methods-The population-based prospective Cohort of Swedish Men included 38 859 men, aged 45 to 79 years, who had no history of stroke, coronary heart disease, or cancer at baseline. Hazard ratios and 95% confidence intervals (95% CIs) were calculated using Cox proportional hazards regression models. Results-During an 11.7 years follow-up, 3097 incident cases of stroke, including 2482 cerebral infarctions and 450 intracerebral hemorrhages, were registered. The hazard ratios of total stroke and cerebral infarction for the highest compared with the lowest quintiles of heme iron intake were 1.16 (95% CI, 1.03-1.31; P trend=0.037) and 1.15 (95% CI, 1.00-1.31; P trend=0.089), respectively. The incidence rates of total stroke per 10 000 person-years were 72.6 in the lowest quintile and 84.4 in the highest. The association was confined to men with body mass index <25 kg/m 2 , the hazard ratios were 1.40 (95% CI, 1.17-1.68; P trend<0.001) for total stroke and 1.38 (95% CI, 1.13-1.70; P trend=0.001) for cerebral infarction; no association was observed among overweight and obese men. There was no association between nonheme iron intake and risk of total stroke and stroke types. Conclusions-Findings

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Serum Ferritin Is a Risk Factor for Stroke in Postmenopausal Women

Cited by 85 publications

References 30 publications

Risk of acute ischemic heart disease in postmenopausal women depends on von Willebrand factor and fibrinogen concentrations, and blood group genotype

Risk of acute ischemic heart disease in postmenopausal women depends on von Willebrand factor and fibrinogen concentrations, and blood group genotype

Iron Stores and HFE Genotypes Are Not Related to Increased Risk of Ischemic Stroke

Heme Iron Intake and Risk of Stroke

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