国家神经系统疾病临床医学研究中心数据管理与共享系统

发表杂志：European journal of neurology

发表类型: Original Contributions

影响因子(IF): 6.288

PMID: 35380744 Pubmed原文链接 全文下载

Despite current standard treatment for ischemic stroke, patients still suffered about 10%-17% risk of recurrent vascular events at 1-year from symptom onset. Increased inflammatory status at baseline has been established to be associated with recurrent vascular events. Residual inflammatory risk (RIR) has gained much interest since the publication of the CANTOS trial (The Canakinumab Anti-inflammatory Thrombosis Outcomes Study) and describes the inflammatory status in patients with known cardiovascular disease. The definition used for high RIR was a high sensitive C-reactive protein (hsCRP) levels ≥2 mg/L or ≥3 mg/L according to different clinical trials. Routine clinical practice includes assessment of residual cholesterol and thrombotic risk in patients with ischemic stroke, as recommended by the AHA/ASA and ESO Guidelines The importance of lowering these risks in patients with ischemic stroke has been well established. Our recent study showed that baseline RIR was associated with 1-year stroke recurrence and poor functional outcome. However, the prevalence of persistent high RIR after ischemic stroke has not been well established. Moreover, clinical outcomes associated with different patterns of RIR are unknown in patients with ischemic stroke and transient ischemic attack (TIA). We aim to determine the prevalence of persistent high RIR in patients with ischemic stroke and TIA, and to evaluate the association with recurrent vascular events at 1 year after symptom onset.

Patients with baseline and 3-month hsCRP measurements were included in this analysis. Patients with no hsCRP levels or only one blood sample with hsCRP level determination were excluded from the analysis. Patients were stratified into four groups according to RIR. High inflammatory status was defined as hsCRP ≥3 mg/L. Patients with two high values were considered as persistent high RIR. Patients with first high, then low hsCRP were considered as attenuated RIR and patients with first low- then high hsCRP were considered as increased RIR. Patients with consistent low hsCRP were labelled as persistent low RIR. The associations between RIR status and 1-year clinical outcomes are assessed. Multivariate Cox/logistic regression models was used to evaluate the association between RIR status and clinical outcomes at 12-month.