Gene Polymorphism in Recurrent Atherothrombotic Infarction Stroke Patients Imran, Sjamsudin T, Rizal A, Maskoen AM Department of Neurology, Medical Faculty, Padjadjaran University, Bandung, Indonesia. Background and Purpose
Gene Polymorphism in Recurrent Atherothrombotic Infarction Stroke Patients
Imran, Sjamsudin T, Rizal A, Maskoen AM
Department of Neurology, Medical Faculty, Padjadjaran University, Bandung, Indonesia
Background and Purpose
Recurrent atherothrombotic infarction stroke is a recurrent strike of stroke after the first one. The efforts of the treatment are focused in preventions and protections all of stroke risks. One of stroke risk that still debated is plasma fibrinogen level, whereas, it theoretically has a potential role in artheriosclerotic process. Plasma fibrinogen level is influenced by genetic and non-genetic factors. Hyperfibrinogenemia is a plasma fibrinogen level > 400 mg/dl. The purpose of this study is to describe the role of fibrinogen as a risk in stroke incidence, and probably based on genetic factors. Hypothetically, recurrent infarction stroke is related to hyperfibrinogenemia based on Gene Polymorphism.
This was a case control study. Samples were atherothrombotic infarction stroke patients who were hospitalized and ambulatory in Hasan Sadikin Hospital Bandung, divided into 3 groups; Recurrent Infarction Stroke (RIS), Current Infarction Stroke (CIS), and Non-Stroke (NS). Variables were Plasma Fibrinogen Level, Gene Polymorphism (-455G/A & -148C/T), and history of hypertension and DM. Plasma fibrinogen levels were measured by Fibri-Prest Automate and polymorphisms were evaluated by Restriction Fragment Length Polymorphism (RFLP) using HaeIII (for -455G/A locus) dan HindIII (for -148C/T locus) restriction enzyme.
Fig 1. The Interpretation Results of RFLP -455G/A Polymorphysm
Fig 2. The Interpretation Results of RFLP -148C/T Polymorphysm
The amount of samples was 258, concised of RIS:
49, CIS: 108, and NS: 101.
Fig 3. CT Scan Image of Infarction Stroke Patient
Fig 4. The Results of RFLP -455G/A Polymorphism
Fig 5. The Results of RFLP -148C/T Polymorphism
Table 1. Univariate Analysis of Stroke Risk Factors
Hyperfibrinogenemia significantly related to atherothrombotic stroke and increased probability the incidence of recurrent stroke. High plasma fibrinogen levels in stroke might caused by some integrated factors. -148C/T -Gene Fibrinogen Polymorphism related to hyperfibrino-genemia directly and its expression might be increased by hypertension and DM.
Keyword: Infarction stroke, Recurrent stroke, Hyperfibrinogenemia, Polymorphism
The results of univariate analysis of factors associated with hyperfibrinogenemia were stroke (OR: 2.092, p=0.008) and hypertension (OR: 1.89, p=0.016), whereas, logistic regression showed some integrated factors associated with hyperfibri-nogenemia were hypertension, DM, and -148C/T -Gene Fibrinogen Polymorphisms (p=0.011, 95%CI).
Acknowledgments:We would like to thank to Eijkman Institute & Litbangkes for their financial support of the study