Abstract W MP49: Carriage of the PlA2 Allele of Glycoprotein IIIa is Associated With an Increased Risk of Ischaemic Stroke: A Meta-Analysis

Abstract

Introduction: The PlA1/A2 polymorphism of glycoprotein IIIa has been associated with an increased risk of stroke, but with poor agreement between studies. Here we present a meta-analysis to assess the hypothesis that carriage of the PlA2 allele increases stroke risk. Methods: Electronic databases (MEDLINE and EMBASE) were searched for all articles evaluating carriage of the PlA2 allele and the incidence of stroke. Pooled odds ratios (ORs) were calculated using fixed-effect and random-effect models. Results: A total of 34 articles were eligible for statistical analysis (5,475 cases and 7,247 controls). For carriage of the PlA2 allele, OR 1.15 (n=12,115; 95% CI=1.05-1.26; p=0.002) was observed for total adult stroke, with sub-group analyses identifying an association with ischaemic (n=9,460; OR 1.22, 95% CI=1.10-1.35; p=0.0001) but not haemorrhagic stroke (n=2,470; OR 0.90, 95% CI=0.73-1.10; p=0.300). Significance was lost for ischaemic stroke in both young adults (18-60yr) (n=1,746; OR 1.26, 95% CI=0.97-1.65; p=0.09) and children (n=334; OR 1.24, 95% CI=0.74-2.08; p=0.41). Significant heterogeneity was observed for total (I2=60.1; p=0.0001) and ischaemic (I2=60.6; p=0.0003) stroke. Significance was lost for total stroke when analysed using a random-effect model (OR 1.15, 95% CI=0.99-1.34; p=0.06), but persisted in the ischaemic stroke sub-group (OR 1.23, 95% CI=1.03-1.46; p=0.02). Egger’s regression test suggested a low probability of publication bias (p>0.1 for all groups). Conclusions: This meta-analysis supports the carriage of the PlA2 allele of glycoprotein IIIa as a risk factor for ischaemic stroke in adults. The totality of published data does not enable sub-group analyses based on sex, ethnicity or traditional cardiovascular risk factors, and so the need for further studies remains.