Study protocol

The Ischemic Stroke Genetics Study (ISGS) Protocol

James F Meschia¹ , Thomas G Brott¹ , Robert D Brown Jr¹ , Richard JP Crook² , Michael Frankel³ , John Hardy⁴ , José G Merino⁵ , Stephen S Rich⁶ , Scott Silliman⁵ and Bradford Burke Worrall⁷

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

author email corresponding author email

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

Published:	8 July 2003

Abstract

Background

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.

Methods/Design

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.

Discussion

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.