|Title||Low protein C and incidence of ischemic stroke and coronary heart disease: the Atherosclerosis Risk in Communities (ARIC) Study.|
|Publication Type||Journal Article|
|Year of Publication||2009|
|Authors||Folsom AR, Ohira T, Yamagishi K, Cushman M|
|Journal||J Thromb Haemost|
|Date Published||2009 Nov|
|Keywords||Brain Ischemia, Cohort Studies, Coronary Disease, Female, Follow-Up Studies, Humans, Incidence, Male, Middle Aged, Prospective Studies, Protein C, Risk Factors, Stroke|
BACKGROUND: Protein C is an important plasma natural anticoagulant. Although protein C deficiency increases risk of venous thrombosis, it remains uncertain whether low protein C increases risk of atherothrombosis.
OBJECTIVE: To examine whether low protein C may be a risk factor for ischemic stroke or coronary events in a prospective population-based study.
PATIENTS/METHODS: The Atherosclerosis Risk in Communities Study assessed protein C antigen by ELISA at baseline in 1987-89 and followed participants (n = 13 879) for incident ischemic stroke or coronary events through 2005.
RESULTS: Over a median of 16.9 years of follow-up, 613 ischemic strokes and 1257 coronary heart disease events occurred. Protein C was inversely associated with incidence of ischemic stroke. Adjusted for multiple risk factors, the rate ratios (95% CIs) from highest to lowest quintiles were 1.0, 1.16 (0.90-1.50), 1.22 (0.94-1.58), 1.18 (0.90-1.55) and 1.52 (1.17-1.98). This inverse association was stronger for non-lacunar and cardioembolic stroke than for lacunar stroke. In contrast, there was a positive association between protein C and coronary heart disease in incompletely adjusted models, but no association after adjustment for plasma lipids.
CONCLUSIONS: In this cohort study, low protein C was a risk factor for incident ischemic stroke but not coronary heart disease. Levels of protein C associated with stroke risk were not restricted to the traditional 'deficient' range for protein C (
|Alternate Journal||J Thromb Haemost|
|PubMed Central ID||PMC2819378|
|Grant List||N01-HC-55022 / HC / NHLBI NIH HHS / United States |
N01-HC-55016 / HC / NHLBI NIH HHS / United States
N01-HC-55021 / HC / NHLBI NIH HHS / United States
N01HC55015 / HL / NHLBI NIH HHS / United States
N01 HC055019 / HC / NHLBI NIH HHS / United States
N01-HC-55019 / HC / NHLBI NIH HHS / United States
N01-HC-55015 / HC / NHLBI NIH HHS / United States
N01-HC-55020 / HC / NHLBI NIH HHS / United States
N01-HC-55018 / HC / NHLBI NIH HHS / United States