Polimorfizm rs2200733 na chromosomie 4q25 jest czynnikiem ryzyka udaru sercowozatorowego związanego z migotaniem przedsionków w populacji polskiej

Background and purpose A few single nucleotide polymorphisms (SNPs) on chromosome 4q25, associated with atrial fibrillation (AF), are risk factors for ischaemic stroke. We studied the significance of the SNP rs2200733 on chromosome 4q25 in different types of cardioembolic (CE) stroke. Material and methods: We genotyped 428 controls and 301 CE stroke patients, among whom 197 (65.4%) presented with high risk sources of embolism (CE stroke related to AF) and 104 with medium risk sources (CE stroke unrelated to AF). The SNP rs2200733 was analysed using real-time polymorphism chain reaction. Results Both univariate and multivariate regression analyses showed that the studied variant affected risk of all CE strokes or CE strokes related to AF in recessive and additive models. The two types of CE stroke differed significantly in demographics and distribution of vascular risk factors. Conclusions The SNP rs2200733 on chromosome 4q25 is a risk factor for CE stroke related to AF only

Polimorfizm rs2200733 na chromosomie 4q25 jest czynnikiem ryzyka udaru sercowozatorowego związanego z migotaniem przedsionków w populacji polskiej

Background and purpose A few single nucleotide polymorphisms (SNPs) on chromosome 4q25, associated with atrial fibrillation (AF), are risk factors for ischaemic stroke. We studied the significance of the SNP rs2200733 on chromosome 4q25 in different types of cardioembolic (CE) stroke. Material and methods: We genotyped 428 controls and 301 CE stroke patients, among whom 197 (65.4%) presented with high risk sources of embolism (CE stroke related to AF) and 104 with medium risk sources (CE stroke unrelated to AF). The SNP rs2200733 was analysed using real-time polymorphism chain reaction. Results Both univariate and multivariate regression analyses showed that the studied variant affected risk of all CE strokes or CE strokes related to AF in recessive and additive models. The two types of CE stroke differed significantly in demographics and distribution of vascular risk factors. Conclusions The SNP rs2200733 on chromosome 4q25 is a risk factor for CE stroke related to AF only.Wstęp i cel pracy Kilka polimorfizmów na chromosomie 4q25, związanych z migotaniem przedsionków, jest czynnikami ryzyka udaru niedokrwiennego mózgu. Przeanalizowano znaczenie polimorfizmu rs2200733 na chromosomie 4q25 w różnych typach udaru sercowozatorowego. Materiał i metody Badany polimorfizm oznaczono u 428 osób tworzących grupę kontrolną oraz u 301 chorych na udar sercowozatorowy, spośród których 197 (65,4%) miało źródło zatorowości o dużym ryzyku (udar sercowozatorowy związany z migotaniem przedsionków), a 104 o pośrednim ryzyku (udar sercowozatorowy niezwiązany z migotaniem przedsionków). Do analizy polimorfizmu rs2200733 wykorzystano reakcję łańcuchową polimerazy DNA z analizą ilości produktu w czasie rzeczywistym. Wyniki Zarówno jedno-, jak i wieloczynnikowa analiza regresji logistycznej wykazały, że badany wariant wpływał na ryzyko wystąpienia wszystkich udarów sercowozatorowych oraz tych związanych z migotaniem przedsionków w modelach recesywnym i addytywnym. Dwa typy udaru sercowozatorowego różniły się w zakresie czynników demograficznych oraz rozkładu naczyniowych czynników ryzyka. Wnioski Polimorfizm rs2200733 na chromosomie 4q25 jest czynnikiem ryzyka jedynie udaru sercowozatorowego związanego z migotaniem przedsionków

Polimorfizm –455G/A genu β-fibrynogenu a ryzyko udaru niedokrwiennego w populacji polskiej

Background and purpose: Ischaemic stroke is considered to be multifactorial and interactions between environmental and genetic factors play an important role. Although vascular risk factors are well known, the genetic ones are still undiscover - ed. In the present study, we assessed the significance of the β-fibrinogen –455G/A gene polymorphism and the risk of ischaemic stroke in a Polish population. Material and methods: 426 ischaemic stroke patients classified according to stroke aetiologies (small vessel disease, large vessel disease or cardioembolic stroke) and 234 controls were included in the study. The association of the β-fibrinogen genotypes with ischaemic stroke was tested using logistic regression analysis under dominant, recessive or additive models of inheritance. Results: The allele and genotype distributions of the β-fibri - nogen –455G/A gene polymorphism did not differ significantly between patients and controls (patients: G – 75%, GG – 56.6%, GA – 36.8%, AA – 6.6%; controls: G – 73.7%, GG – 57.3%, GA – 32.9%, AA – 9.8%; p > 0.05, χ2). In addition, logistic regression analysis adjusted for the known risk factors, i.e. hypertension, ischaemic heart disease, myocardial infarction, hypercholesterolaemia, diabetes mellitus and smoking, did not show a role of the studied polymorphism in ischaemic stroke. Conclusions: The β-fibrinogen –455G/A gene polymorphism is not a risk factor for ischaemic stroke in a Polish population

Mechanical thrombectomy in acute stroke – Five years of experience in Poland

Objectives Mechanical thrombectomy (MT) is not reimbursed by the Polish public health system. We present a description of 5 years of experience with MT in acute stroke in Comprehensive Stroke Centers (CSCs) in Poland. Methods and results We retrospectively analyzed the results of a structured questionnaire from 23 out of 25 identified CSCs and 22 data sets that include 61 clinical, radiological and outcome measures. Results Most of the CSCs (74%) were founded at University Hospitals and most (65.2%) work round the clock. In 78.3% of them, the working teams are composed of neurologists and neuro-radiologists. All CSCs perform CT and angio-CT before MT. In total 586 patients were subjected to MT and data from 531 of them were analyzed. Mean time laps from stroke onset to groin puncture was 250±99min. 90.3% of the studied patients had MT within 6h from stroke onset; 59.3% of them were treated with IV rt-PA prior to MT; 15.1% had IA rt-PA during MT and 4.7% – emergent stenting of a large vessel. M1 of MCA was occluded in 47.8% of cases. The Solitaire device was used in 53% of cases. Successful recanalization (TICI2b–TICI3) was achieved in 64.6% of cases and 53.4% of patients did not experience hemorrhagic transformation. Clinical improvement on discharge was noticed in 53.7% of cases, futile recanalization – in 30.7%, mRS of 0–2 – in 31.4% and mRS of 6 in 22% of cases. Conclusion Our results can help harmonize standards for MT in Poland according to international guidelines

Mechanical thrombectomy in acute stroke : five years of experience in Poland

Objectives: Mechanical thrombectomy (MT) is not reimbursed by the Polish public health system. We present a description of 5 years of experience with MT in acute stroke in Comprehensive Stroke Centers (CSCs) in Poland. Methods and results: We retrospectively analyzed the results of a structured questionnaire from 23 out of 25 identified CSCs and 22 data sets that include 61 clinical, radiological and outcome measures. Results: Most of the CSCs (74%) were founded at University Hospitals and most (65.2%) work round the clock. In 78.3% of them, the working teams are composed of neurologists and neuro-radiologists. All CSCs perform CT and angio-CT before MT. In total 586 patients were subjected to MT and data from 531 of them were analyzed. Mean time laps from stroke onset to groin puncture was 250 99 min. 90.3% of the studied patients had MT within 6 h from stroke onset; 59.3% of them were treated with IV rt-PA prior to MT; 15.1% had IA rt-PA during MT and 4.7% - emergent stenting of a large vessel. M1 of MCA was occluded in 47.8% of cases. The Solitaire device was used in 53% of cases. Successful recanalization (TICI2b–TICI3) was achieved in 64.6% of cases and 53.4% of patients did not experience hemorrhagic transformation. Clinical improvement on discharge was noticed in 53.7% of cases, futile recanalization - in 30.7%, mRS of 0–2 - in 31.4% and mRS of 6 in 22% of cases. Conclusion: Our results can help harmonize standards for MT in Poland according to international guideline