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
Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Associations between admission levels of multiple biomarkers and subsequent worse outcomes in acute ischemic stroke patients
第一作者：Wei-Li Jia
基本信息
- 负责人：Wei-Li Jia
- 数据来源： CNSR-Ⅲ
- 论文编号：CNSR-Ⅲ20230206
- 发表时间：2023-11-17
2023-11-17
已发表文章
发表杂志：Journal of Cerebral Blood Flow & Metabolism
发表类型: Article
影响因子(IF): 6.3
PMID: 37975323 Pubmed原文链接 全文下载
主要研究背景及目的
The modified Rankin Scale change score (ΔmRS) is useful for evaluating acute poststroke functional improvement or deterioration. We investigated the relationship between multiple biomarkers and ΔmRS in acute ischemic stroke.
方法
We included 6931 patients with acute ischemic stroke (average age 62.3±11.3 years, 2174 (31.4%) female) enrolled from the Third China National Stroke Registry (CNSR-III) and 15 available biomarkers. Worse outcomes at 3 months were defined as ΔmRS3m-discharge≥1 (mRS3m-mRSdischarge=ΔmRS3m-discharge). Cox models or logistic regression models were used to analyze the relationship between worse outcomes and biomarkers. Hazard ratios (HRs) and odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated.
结论
This study indicated that WBCs, hs-CRP, IL-6, IL-1Ra, and YKL-40 were significantly associated with worse outcomes in acute ischemic stroke patients, and all inflammatory biomarkers except YKL-40 were independent predictors of worse outcomes at 3 months.
主要结果
At 3-months poststroke, 1026 (14.8%) patients experienced worse outcomes. The highest quartiles of white blood cells (WBCs) (aOR [95%CI],1.37 [1.12-1.66]), high-sensitivity C-reactive protein (hs-CRP) (1.37 [1.12-1.67]), interleukin-6 (IL-6) (1.43 [1.16-1.76]), interleukin-1 receptor antagonist (IL-1Ra) (1.46 [1.20-1.78]) and YKL-40 (1.31 [1.06-1.63]) were associated with an increased risk of worse outcomes at 3 months. Results remained stable except for YKL-40 when simultaneously adding multiple biomarkers to the basic traditional-risk-factor model. Similar results were observed at 6 and 12 months after stroke.