PMID- 31429114

OWN - NLM
STAT- Publisher
LR - 20190820
IS - 1096-8652 (Electronic)
IS - 0361-8609 (Linking)
DP - 2019 Aug 19
TI - Thirty-Year Risk of Ischemic Stroke in Individuals with Sickle Cell Trait and
Modification by Chronic Kidney Disease: The Atherosclerosis Risk in
Communities
(ARIC) Study.
LID - 10.1002/ajh.25615 [doi]
AB - Sickle cell trait (SCT) has been associated with hypercoagulability, chronic
kidney disease (CKD), and ischemic stroke. Whether concomitant CKD modifies
long-term ischemic stroke risk in individuals with SCT is uncertain. We
analyzed
data from 3,602 genotyped black adults (female=62%, mean baseline age = 54
years)
who were followed for a median 26 years by the Atherosclerosis Risk in
Communities Study. Ischemic stroke was verified by physician review.
Associations
between SCT and ischemic stroke were analyzed using repeat-events Cox
regression,
adjusted for potential confounders. SCT was identified in 236 (7%)
participants,
who more often had CKD at baseline than noncarriers (18% vs. 13%, P=0.02).
Among
those with CKD, elevated factor VII activity was more prevalent with SCT
genotype
(36% vs. 22%; P=0.05). From 1987-2017, 555 ischemic strokes occurred in 436
individuals. The overall hazard ratio of ischemic stroke associated with SCT
was
1.31 (95% CI: 0.95 - 1.80) and was stronger in participants with concomitant
CKD
(HR = 2.18; 95% CI: 1.16 - 4.12) than those without CKD (HR = 1.09; 95% CI:
0.74
- 1.61); P for interaction = 0.04. The hazard ratio of composite ischemic
stroke
and / or death associated with SCT was 1.20 (95% CI: 1.01 - 1.42) overall,
1.44
(95% CI: 1.002 - 2.07) among those with CKD, and 1.15 (95% CI: 0.94 - 1.39)
among
those without CKD; P for interaction = 0.18. The long-term risk of ischemic
stroke associated with SCT relative to noncarrier genotype appears to be
modified
by concomitant CKD. This article is protected by copyright. All rights
reserved.
CI - This article is protected by copyright. All rights reserved.
FAU - Caughey, Melissa C
AU - Caughey MC
AUID- ORCID: https://orcid.org/0000-0001-8433-5147
AD - Department of Medicine, University of North Carolina at Chapel Hill, Chapel
Hill,
NC.
FAU - Derebail, Vimal K
AU - Derebail VK
AD - Department of Medicine, University of North Carolina at Chapel Hill, Chapel
Hill,
 NC.
FAU - Key, Nigel S
AU - Key NS
AD - Department of Medicine, University of North Carolina at Chapel Hill, Chapel
Hill,
NC.
FAU - Reiner, Alexander P
AU - Reiner AP
AD - Department of Epidemiology, University of Washington, Seattle, WA.
FAU - Gottesman, Rebecca F
AU - Gottesman RF
AD - Department of Neurology, Johns Hopkins University, Baltimore, MD.
FAU - Kshirsagar, Abhijit V
AU - Kshirsagar AV
AD - Department of Medicine, University of North Carolina at Chapel Hill, Chapel
Hill,
NC.
FAU - Heiss, Gerardo
AU - Heiss G
AD - Department of Epidemiology, University of North Carolina at Chapel Hill,
Chapel
Hill, NC.
LA - eng
PT - Journal Article
DEP - 20190819
PL - United States
TA - Am J Hematol
JT - American journal of hematology
JID - 7610369
SB - IM
EDAT- 2019/08/21 06:00
MHDA- 2019/08/21 06:00
CRDT- 2019/08/21 06:00
PHST- 2019/05/28 00:00 [received]
PHST- 2019/07/29 00:00 [revised]
PHST- 2019/08/08 00:00 [accepted]
PHST- 2019/08/21 06:00 [entrez]
PHST- 2019/08/21 06:00 [pubmed]
PHST- 2019/08/21 06:00 [medline]
AID - 10.1002/ajh.25615 [doi]
PST - aheadofprint
SO - Am J Hematol. 2019 Aug 19. doi: 10.1002/ajh.25615.