Abstract
Cerebrovascular accidents (CVAs) are vascular multifactorial, multigenic ailments with intricate genetic, environmental risk influences. The present study aimed to establish affiliation of CVAs/stroke with blood parameters, differences in prescribed drugs consumption, and with differences in homocysteine pathway genes polymorphisms. The participants in study included controls n = 251, transient ischemic attack (TIA) patients n = 16, and stroke cases n = 122, respectively, (total participants, n = 389). The analyzed single nucleotide polymorphisms (SNPs) included C677T(rs1801133), A1298C(rs1801131) of methylene tetrahydrofolate reductase ( MTHFR ), A2756G(rs1805087) of methyl tetrahydrofolate homocysteine methyltransferase/methionine synthase ( MS ), and the A192G(rs662) of paraoxonase 1( PON1 ) genes, all validated by tetra-primer allele refractory mutation system polymerase chain reaction (T-ARMS-PCR). The insertion deletion (I/D; rs4646994) polymorphism in angiotensin converting enzyme ( ACE ) gene was analyzed using routine PCR. All studied traits were scrutinized through analysis of variance (ANOVA), and later through regression analysis. Through ANOVA and multiple comparison, there was association of CVA with serum homocysteine, cholesterol, and with diastolic blood pressure readings. When data was subjected to regression, serum homocysteine and diastolic blood pressure (significant through ANOVA), as well as two additional traits, high-density lipoproteins (HDL), and rs1801133 MTHFR SNP sustained statistical significance and noteworthy odds in relation to CVA and stroke. The ailments affecting cerebral vasculature are mutifactorial, whereby genes, proteins, and environmental cues all exert cumulative effects enhancing CVA risk. The current study emphasizes that SNPs and variation in circulating biomarkers can be used for screening purposes and for reviewing their effects in stroke/CVA-linked risk progression.
Highlights
Stroke/cerebrovascular accidents (CVAs) are common in both the developed nations as well as developing nations and pose a raised national and international socioeconomic burden.[1]
There is scarcity of studies aimed at elucidation of genetic variants and variances in medication intake as related to causation/risk stratification of strokes, Cerebrovascular accidents (CVAs)
Current study worked on interaction of novel genetic variants, serum-based factors, and traditional vascular disease risk influences, that may manifest as stroke
Summary
Stroke/cerebrovascular accidents (CVAs) are common in both the developed nations as well as developing nations and pose a raised national and international socioeconomic burden.[1] Stroke represents weakness/loss of power in extremities, secondary to abnormal brain tissue perfusion, which in turn is subsequent to ischemic or hemorrhagic cerebral vessels. Ischemic stroke (following thrombosis or infarction) is much more common than the hemorrhagic cerebral disease, comprising more than four-fifths of the cases, with males affected more than females.[2] The prevalence of stroke numbers in millions and a great majority of affected patients suffer from lifelong debility, incapacity, and even fatal outcomes. In Pakistan, there are four million stroke cases, with the rate of CVA/stroke being five to 10 times higher as compared with United Kingdom or United States.[6,7] The number of stroke afflicted persons, in Pakistan, was around 80 of every 0.1 million individuals in year 2010, and number will greatly increase in the coming years.[4,5]
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