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www.themegallery.c om Gene Polymorphism in Recurrent Atherothrombotic Infarction Stroke Patients Imran, Sjamsudin T, Rizal A, Maskoen AM Department of Neurology, Medical Faculty, Padjadjaran University, Bandung, Indonesia Background and Purpose Recurrent atherothrombotic infarction stroke is a recurrent strike of stroke after the first one. The efforts of the treatment are focused in preventions and protections all of stroke risks. One of stroke risk that still debated is plasma fibrinogen level, whereas, it theoretically has a potential role in artheriosclerotic process. Plasma fibrinogen level is influenced by genetic and non-genetic factors. Hyperfibrinogenemia is a plasma fibrinogen level > 400 mg/dl. The purpose of this study is to describe the role of fibrinogen as a risk in stroke incidence, and probably based on genetic factors. Hypothetically, recurrent infarction stroke is related to hyperfibrinogenemia based on Gene Polymorphism. Methods This was a case control study. Samples were atherothrombotic infarction stroke patients who were hospitalized and ambulatory in Hasan Sadikin Hospital Bandung, divided into 3 groups; Recurrent Infarction Stroke (RIS), Current Infarction Stroke (CIS), and Non-Stroke (NS). Variables were Plasma Fibrinogen Level, Gene Polymorphism (-455G/A & -148C/T), and history of hypertension and DM. Plasma fibrinogen levels were measured by Fibri-Prest Automate and polymorphisms were evaluated by Restriction Fragment Length Polymorphism (RFLP) using HaeIII (for -455G/A locus) dan HindIII (for -148C/T locus) restriction enzyme. Results The amount of samples was 258, concised of RIS: 49, CIS: 108, and NS: 101. 411.7 392.3 365.4 340 360 380 400 420 Fibrinogen Level(m g/dl) 1 Sam ple G roups p = 0.017,C I95% Fibrinogen LevelAverages B ased on Sam ple G roups RIS CIS NS No Variables Sample OR p Stroke (RIS/ CIS) Non-Stroke (NS) 1 Hypertension Yes 117 14 18.17 7 0.000 No 40 87 2 Fibrinogen Level (mg/dl) > 400 66 26 2.092 0.008 < 400 91 75 3 Smoking Yes 50 19 2.017 0.021 No 107 82 4 Age (Year) > 45 128 70 1.955 0.023 < 45 29 31 5 DM Yes 33 13 1.801 0.095 No 124 88 Conclusions: Hyperfibrinogenemia significantly related to atherothrombotic stroke and increased probability the incidence of recurrent stroke. High plasma fibrinogen levels in stroke might caused by some integrated factors. -148C/T -Gene Fibrinogen Polymorphism related to hyperfibrino-genemia directly and its expression might be increased by hypertension and DM. Keyword: Infarction stroke, Recurrent stroke, Hyperfibrinogenemia, Polymorphism Acknowledgments: We would like to thank to Eijkman Institute & Litbangkes for their financial support of the study The results of univariate analysis of factors associated with hyperfibrinogenemia were stroke (OR: 2.092, p=0.008) and hypertension (OR: 1.89, p=0.016), whereas, logistic regression showed some integrated factors associated with hyperfibri-nogenemia were hypertension, DM, and -148C/T -Gene Fibrinogen Polymorphisms (p=0.011, 95%CI). Fig 4. The Results of RFLP - 455G/A Polymorphism Fig 5. The Results of RFLP - 148C/T Polymorphism Fig 3. CT Scan Image of Infarction Stroke Patient Table 1. Univariate Analysis of Stroke Risk Factors Fig 1. The Interpretation Results of RFLP -455G/A Polymorphysm Fig 2. The Interpretation Results of RFLP -148C/T Polymorphysm 407.5 392.3 377.6 360 370 380 390 400 410 Fibrinogen Level (m g/dl) 1 Genotype Variations p = 0.34 C I95% Fibrinogen LevelAverages B ased on -455G /A Polym orphism G enotype Variations AA GA GG 396.7 399.7 371.9 350 360 370 380 390 400 Fibrinogen Level(mg/dl) 1 Genotype Variations p = 0.111 CI95% Fibrinogen LevelAverages B ased on -148C /T Polym orphism G enotype Variations TT CT CC
