Can Biomarkers Identify Women at Increased Stroke Risk?
Author Information
Author(s): Charles Kooperberg, Mary Cushman, Judith Hsia, Jennifer G. Robinson, Aaron K. Aragaki, John K. Lynch, Alison E. Baird, Karen C. Johnson, Lewis H. Kuller, Shirley A. Beresford, Beatriz Rodriguez
Primary Institution: Fred Hutchinson Cancer Research Center
Hypothesis
Can biomarkers identify women who are at lower or higher risk for stroke with postmenopausal hormone therapy?
Conclusion
Biomarkers did not identify women at higher stroke risk with postmenopausal hormone therapy, and some biomarkers appeared to identify women at lower stroke risk, but these findings may be due to chance.
Supporting Evidence
- 205 women who experienced a stroke were compared to 878 control individuals.
- Women with higher baseline levels of some stroke-associated biomarkers had a lower risk of stroke when assigned to estrogen plus progestin compared to placebo.
- Only an interaction of D-dimer during follow-up with hormone therapy and stroke was marginally significant.
Takeaway
The study looked at whether certain blood markers could help predict if women would have a stroke when taking hormone therapy after menopause. It found that these markers didn't really help identify those at risk.
Methodology
The study was a nested case-control study within the Women's Health Initiative hormone trials, analyzing biomarkers in women who experienced strokes compared to controls.
Potential Biases
The analysis of multiple biomarkers raises concerns about the potential for chance findings.
Limitations
The study had a relatively small number of strokes, limiting the power to detect associations, and the findings may not be generalizable to the broader population.
Participant Demographics
Participants were 27,347 postmenopausal women aged 50–79 years.
Statistical Information
P-Value
p = 0.02 for IL-6, p = 0.03 for D-dimer
Confidence Interval
95% CI 1.01–2.32 for unadjusted OR of stroke for active treatment
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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