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The Ischemic Stroke Genetics Study (ISGS) Protocol

James F Meschia1*, Thomas G Brott1, Robert D Brown1, Richard JP Crook2, Michael Frankel3, John Hardy4, José G Merino5, Stephen S Rich6, Scott Silliman5 and Bradford Burke Worrall7

Author Affiliations

1 Department of Neurology, Mayo Clinic, Jacksonville, Florida, U.S.A

2 Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, U.S.A

3 Emory University School of Medicine, Atlanta, Georgia, U.S.A

4 National Institute on Aging, Bethesda, Maryland, U.S.A

5 University of Florida/Shands Hospital, Jacksonville, Florida, U.S.A

6 Department of Public Health Sciences and Neurology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, U.S.A

7 University of Virginia Health System, Charlottesville, Virginia, U.S.A

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BMC Neurology 2003, 3:4  doi:10.1186/1471-2377-3-4

Published: 8 July 2003



The molecular basis for the genetic risk of ischemic stroke is likely to be multigenic and influenced by environmental factors. Several small case-control studies have suggested associations between ischemic stroke and polymorphisms of genes that code for coagulation cascade proteins and platelet receptors. Our aim is to investigate potential associations between hemostatic gene polymorphisms and ischemic stroke, with particular emphasis on detailed characterization of the phenotype.


The Ischemic Stroke Genetic Study is a prospective, multicenter genetic association study in adults with recent first-ever ischemic stroke confirmed with computed tomography or magnetic resonance imaging. Patients are evaluated at academic medical centers in the United States and compared with sex- and age-matched controls. Stroke subtypes are determined by central blinded adjudication using standardized, validated mechanistic and syndromic classification systems. The panel of genes to be tested for polymorphisms includes β-fibrinogen and platelet glycoprotein Ia, Iba, and IIb/IIIa. Immortalized cell lines are created to allow for time- and cost-efficient testing of additional candidate genes in the future.


The study is designed to minimize survival bias and to allow for exploring associations between specific polymorphisms and individual subtypes of ischemic stroke. The data set will also permit the study of genetic determinants of stroke outcome. Having cell lines will permit testing of future candidate risk factor genes.