open access

Vol 52, No 3 (2018)
Original research articles
Submitted: 2017-11-09
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Alpha-2-antiplasmin Arg407Lys polymorphism and cryptogenic ischemic cerebrovascular events: Association with neurological deficit

Joanna Wzorek, Marek Karpiński, Ewa Wypasek, Michał Michalski, Andrzej Szczudlik, Krzysztof Piotr Malinowski, Anetta Undas
DOI: 10.1016/j.pjnns.2017.12.009
·
Neurol Neurochir Pol 2018;52(3):352-358.

open access

Vol 52, No 3 (2018)
Original research articles
Submitted: 2017-11-09

Abstract

Objective

Genetic background of cryptogenic ischemic stroke (IS) and transient ischemic attack (TIA) remains uncertain. Alpha-2-antiplasmin (α2AP) Arg407Lys polymorphism has been shown to be less common in patients with abdominal aortic aneurysm (AAA) compared with healthy controls. We investigated associations of α2AP Arg407Lys polymorphism with cryptogenic IS and TIA.

Methods

We studied 165 consecutive Caucasian patients who experienced cryptogenic IS (n=123) or TIA (n=42). Neurological outcomes were assessed using the modified Rankin Scale (mRS) in the acute phase of cerebral ischemia and 8 (6–12) months after the index episode. Patients were genotyped for α2AP Arg407Lys polymorphism (rs1057335) using real time PCR technique.

Results

The allele frequency of Arg407Lys polymorphism was: 0.82/0.18. The 407Lys allele was more frequent in TIA patients compared to the IS group (0.29 vs. 0.14, p=0.003). In the whole group, as well as in IS and TIA patients analyzed separately, possession of the 407Lys allele was associated with excellent outcome (mRS 0–1) during follow-up (p<0.05) but not in the acute phase of ischemic events both in thrombolyzed and nonthrombolyzed IS patients.

The multivariate logistic regression model showed that the excellent outcome (mRS 0–1) assessed after 8 (6–12) months since the index cerebral ischemia was predicted by the occurrence of Lys407 allele (OR 6.18, 95% CI, 2.01–18.98, p=0.001).

Conclusion

The presence of 407Lys allele is associated with better prognosis in cryptogenic cerebrovascular events. Our findings suggest that the α2AP Arg407Lys polymorphism could be involved in the pathogenesis of cerebral ischemia and its outcomes.

Abstract

Objective

Genetic background of cryptogenic ischemic stroke (IS) and transient ischemic attack (TIA) remains uncertain. Alpha-2-antiplasmin (α2AP) Arg407Lys polymorphism has been shown to be less common in patients with abdominal aortic aneurysm (AAA) compared with healthy controls. We investigated associations of α2AP Arg407Lys polymorphism with cryptogenic IS and TIA.

Methods

We studied 165 consecutive Caucasian patients who experienced cryptogenic IS (n=123) or TIA (n=42). Neurological outcomes were assessed using the modified Rankin Scale (mRS) in the acute phase of cerebral ischemia and 8 (6–12) months after the index episode. Patients were genotyped for α2AP Arg407Lys polymorphism (rs1057335) using real time PCR technique.

Results

The allele frequency of Arg407Lys polymorphism was: 0.82/0.18. The 407Lys allele was more frequent in TIA patients compared to the IS group (0.29 vs. 0.14, p=0.003). In the whole group, as well as in IS and TIA patients analyzed separately, possession of the 407Lys allele was associated with excellent outcome (mRS 0–1) during follow-up (p<0.05) but not in the acute phase of ischemic events both in thrombolyzed and nonthrombolyzed IS patients.

The multivariate logistic regression model showed that the excellent outcome (mRS 0–1) assessed after 8 (6–12) months since the index cerebral ischemia was predicted by the occurrence of Lys407 allele (OR 6.18, 95% CI, 2.01–18.98, p=0.001).

Conclusion

The presence of 407Lys allele is associated with better prognosis in cryptogenic cerebrovascular events. Our findings suggest that the α2AP Arg407Lys polymorphism could be involved in the pathogenesis of cerebral ischemia and its outcomes.

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Keywords

α-2-Antiplasmin, Arg407Lys polymorphism, Ischemic stroke, Transient ischemic attack

About this article
Title

Alpha-2-antiplasmin Arg407Lys polymorphism and cryptogenic ischemic cerebrovascular events: Association with neurological deficit

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 52, No 3 (2018)

Pages

352-358

DOI

10.1016/j.pjnns.2017.12.009

Bibliographic record

Neurol Neurochir Pol 2018;52(3):352-358.

Keywords

α-2-Antiplasmin
Arg407Lys polymorphism
Ischemic stroke
Transient ischemic attack

Authors

Joanna Wzorek
Marek Karpiński
Ewa Wypasek
Michał Michalski
Andrzej Szczudlik
Krzysztof Piotr Malinowski
Anetta Undas

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