The PlA1/A2 polymorphism of glycoprotein IIIa as a risk factor for stroke: a systematic review and meta-analysis.

ABSTRACT: BACKGROUND:The PlA1/A2 polymorphism of glycoprotein IIIa (GPIIIa) has been reported to be associated with risk of stroke in some studies, although other studies suggest no such association. This meta-analysis and systematic review was conducted to investigate the hypothesis that carriage of the PlA2 allele is a risk factor for stroke. 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. FINDINGS:A total of 35 articles were eligible for inclusion, of which 25 studies were suitable for statistical analysis. For carriage of the PlA2 allele, OR 1.12 (n?=?11,873; 95% CI?=?1.03-1.22; p?=?0.011) was observed for the incidence of stroke in adults, with subgroup analyses identifying the association driven by stroke of an ischaemic (n?=?10,494; OR?=?1.15, 95% CI?=?1.05-1.27; p?=?0.003) but not haemorrhagic aetiology (n?=?2,470; OR?=?0.90, 95% CI?=?0.71-1.14; p?=?0.398). This association with ischaemic stroke was strongest in individuals homozygous for the PlA2 allele compared to those homozygous for wild-type PlA1 (n?=?5,906; OR?=?1.74, 95% CI?=?1.34-2.26; p<0.001). Subgroup analysis of ischaemic stroke subtypes revealed an increased association with stroke of cardioembolic (n?=?1,271; OR 1.56, 95% CI 1.14-2.12; p?=?0.005) and large vessel (n?=?1,394; OR?=?1.76, 95% CI 1.34-2.31; p<0.001) aetiology, but not those of small vessel origin (n?=?1,356; OR?=?0.99, 95% CI 0.74-1.33; p?=?0.950). Egger's regression test suggested a low probability of publication bias for all analyses (p>0.05). CONCLUSIONS:The totality of published data supports the hypothesis that carriage of the PlA2 polymorphism of GPIIIa is a risk factor for ischaemic strokes, and specifically those of cardioembolic and large vessel origin.

SUBMITTER: Floyd CN 

PROVIDER: S-EPMC4079245 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature