Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

Journal：Journal of neuroinflammation

Publication type: Original Contributions

IF(IF): 9.587

PMID: 35761288 Link To Pubmed Full text Download

Multiple strands of experimental and clinical data implicate that both systemic and intravascular inflammation contribute to development and progression of stroke. The markers for systemic inflammation, such as interleukin-6 (IL-6) and high sensitive C-reactive protein (hsCRP) , and local vascular inflammation, such as Lipoprotein-associated phospolipase A2 (Lp-PLA2) mass and activity and YKL-40 have been shown to be associated with incidence and prognosis of stroke. IL-6 receptor (IL-6R) is a member of IL-6 signaling cascade. A Mendelian randomisation analysis suggest a causal link between IL-6R and cardiovascular disease, and high levels of IL-6R have been found to be related with subsequent cardiovascular disease and mortality. Another systemic inflammatory mediator of interleukin-1β (IL-1β), residing upstream in the IL-6 pathway, has recently come to the fore as a therapeutic target to reduce recurrent cardiovascular events. IL-1 receptor antagonist (IL-1Ra) is an endogemous inhibitor of IL-1β, and IL-1β induces its production. Since a direct measurement of IL-1β is not applicable due to extremely low plasma levels, IL-1Ra can serve as a detectable surrogate parameter for high IL-1β activity, and has been found to be an independent predictor of poor prognosis of cardiovascular disease. However, there is limited data from large multicenter prospective studies about the role of systemic and intravascular inflammatory markers in the prognosis of stroke. The Third China National Stroke Registry (CNSR-III) included patient with acute ischemic cerebrovascular events aiming to identify the biological markers for prognosis of ischemic cerebrovascular events and facilitate early evaluation and identification of patients at high risk. In this analysis ,we sought to specifically investigate the effect of systemic and local vascular inflammatory biomarkers.

The associations of each inflammatory marker with recurrence of stroke and cardiovascular death were investigated with the use of Cox proportional hazards models. Kaplan–Meier survival curves was used to depict the occurrence of recurrent stroke. The association of each marker with poor functional outcome was analyzed via logistic regression model.