RESUMEN
BACKGROUND: Previous data are conflicting as to whether imbalance between hemostatic factors is associated with clinical strokes. We evaluated the association between hemostatic factor levels and subclinical lacunar infarcts in a nested sample from a subset of the Atherosclerosis Risk in Communities (ARIC) cohort. METHODS: 196 cases without clinical strokes had lacunar infarcts by MRI, and 214 controls without radiographic infarcts were frequency-matched by age group and sex. Logistic regression models were fitted to assess the association between levels of hemostatic markers and case status. RESULTS: In age-, race- and sex-adjusted models, von Willebrand factor (vWF) and D-dimer were positively associated with case status, with odds ratios for the highest vs. lowest tertile of 2.0 (95% CI 1.2-3.6) for vWF and 1.76 (95% CI 1.02-3.0) for D-dimer. Plasminogen had nonsignificant inverse associations with presence of silent lacunar infarcts. CONCLUSIONS: vWF and D-dimer were positively associated, and plasminogen was nonsignificantly inversely associated with subclinical radiographic infarct. Further studies on the role of these hemostatic factors in the development of silent lacunar infarcts may help elucidate the mechanisms behind this injury and may even point to potential targets for future intervention.
Asunto(s)
Infarto Encefálico/sangre , Infarto Encefálico/epidemiología , Productos de Degradación de Fibrina-Fibrinógeno/metabolismo , Plasminógeno/metabolismo , Factor de von Willebrand/metabolismo , Aterosclerosis/epidemiología , Biomarcadores/sangre , Infarto Encefálico/patología , Estudios de Casos y Controles , Estudios Transversales , Femenino , Humanos , Modelos Logísticos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Factores de Riesgo , Estados Unidos/epidemiologíaRESUMEN
Measures of transient evoked otoacoustic emission (TEOAE) reproducibility were obtained for 506 ears of 260 children and young adults. Frequency-specific and whole reproducibility data were obtained using ILO88 hardware and software (version 3.92), and were analyzed with respect to pure tone threshold and emmittance data for the same ears. The 2,000-Hz reproducibility score was the most efficient of all measurements (0.85-0.91) in separating normal and hearing-impaired ears, regardless of the frequencies at which the hearing loss occurred. TEOAE reproducibility measures may be very useful in screening for hearing loss in babies, leading to the earliest identification of children with hearing loss.