Abstract
Background:
Chronic infections and hemodynamic dysfunction are risk factors for stroke. We hypothesized that blood biomarkers of infection (procalcitonin, or PCT) and hemodynamic stress (midregional pro-atrial natriuretic peptide, or MRproANP) would be associated with subclinical cerebrovascular damage (SCVD), including silent brain infarcts (SBI) and white matter hyperintensity volume (WMHV).
Methods:
The Northern Manhattan Study was designed to assess risk factors for incident vascular disease in a multiethnic cohort. A subsample underwent brain MRI and had blood samples available for biomarker measurement (n=1178). We used logistic regression models to estimate the odds ratios and 95% confidence intervals (OR, 95%CI) for the association of these biomarkers with SBI, and linear regression for associations with logWMHV, after adjusting for demographic, behavioral, and medical risk factors.
Results:
Mean age was 70 ±9 years; 60% were women, 66% hispanic, 17% black, 15% white and 2% belonged to other ethnicities. After fully adjusting for risk factors, subjects with PCT or MRproANP in the top quartile, compared to the lowest quartile, were associated with greater odds of having SBI (adjusted OR for PCT 2.2, 95%CI 1.3-3.7; for MRproANP 3.3, 95%CI 1.7-6.3) and increased WMHV (adjusted mean change in logWMHV for PCT 0.29, 95%CI 0.13-0.44; for MRproANP 0.18,95%CI 0.003-0.36).
Conclusion:
Higher concentrations of PCT, a marker of infection, and MRproANP, a marker of hemodynamic stress, are independently associated with SCVD. Future biomarker- guided primary prevention studies may lead to new approaches to prevent cerebrovascular damage.