Logo image
Abstract P389: Smoking, Biomarkers and Ischemic Stroke Risk: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Cohort
Journal article

Abstract P389: Smoking, Biomarkers and Ischemic Stroke Risk: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Cohort

Juan Conde, Maxwell Pistilli, Timothy Plante, Neil Zakai, Leslie McClure, Nels Olson, George Howard and Mary Cushman
Circulation (New York, N.Y.), v 139(Suppl_1)
05 Mar 2019

Abstract

Introduction: Identifying biological pathways that mediate the increased stroke risk in smokers may allow study of novel strategies to reduce risk. In the REGARDS study, we evaluated the association of smoking status with incident stroke and assessed biomarkers as mediators of smoking related stroke. Methods: 30,239 black and white adults aged 45 and older were enrolled in 2003-7, and followed for incident stroke. Biomarkers were measured in a case cohort substudy and compared across groups of smoking status (never, former or current). Hazard ratios (HRs) of stroke by smoking status and by pack years were calculated using Cox proportional hazards models. Results: Among 1,224 participants with biomarker data (mean age 62, 50% male, 50% black) there were 531 incident stroke cases over 12.9 yrs maximal follow up. Compared to never smokers, the multivariable (age, race, sex and Framingham risk factors) adjusted HR of stroke in current smokers was 1.30 (95% CI 1.11, 1.53) and in former smokers was 1.18 (95% CI 1.05, 1.32). The association of pack years with stroke was substantial in current smokers and weak in former smokers in the adjusted model (Table). Among 7 biomarkers, white blood count, interleukin-6 (IL-6) and fibrinogen were higher in former and current smokers, and with increasing pack years in both groups (data not shown). The association of pack years with stroke in current smokers was partly attenuated with adjustment for IL-6, but not white count or fibrinogen. Among former smokers, white count fully attenuated the weak association. Conclusions: Former and current smoking, and pack years (primarily among current smokers) were stroke risk factors in a contemporary biracial cohort. Among both current and former smokers, smoking-related stroke risk was attenuated after adjustment for IL-6 and white count respectively, suggesting biological pathways for intervention.

Metrics

7 Record Views

Details

InCites Highlights

Data related to this publication, from InCites Benchmarking & Analytics tool:

Collaboration types
Domestic collaboration
Web of Science research areas
Cardiac & Cardiovascular Systems
Peripheral Vascular Disease
Logo image