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

《国家中心数据管理与共享系统操作说明书 —— 研究者部分》

Lp-PLA2 and Dual Antiplatelet in Transient Ischemic Attack and Minor Stroke With Intracranial Arterial Stenosis

第一作者：杨明 王安心

通讯作者：王拥军

Lp-PLA2 stroke dual antiplatelet

基本信息

2020-01-15

已发表文章

发表杂志：Neurology

发表类型: Original Contributions

影响因子(IF): 9.91

PMID: 31822574 Pubmed原文链接 全文下载

主要研究背景及目的

Lp-PLA2是动脉粥样硬化的特征性炎症指标。CHANCE前期研究已经证实Lp-PLA2活性可以预测血管事件的复发。本论文研究是否合并ICAS与Lp-PLA2活性水平对于单双抗疗效的交互作用。旨在进一步发现更适合双抗治疗的人群特点。

方法

Cox proportional hazards regressions

结论

Presence of both ICAS and non-elevated Lp-PLA2 activity may predict better response to dual antiplatelet therapy in prevention of recurrent strokes and combined vascular events for patients with minor stroke or high-risk TIA.

主要结果

There are significantly more patients with elevated Lp-PLA2 activity in the ICAS group than that in the non-ICAS group (43.8% versus 35.4%, p=0.02). There was significant interaction between Lp-PLA2 activity levels and the two antiplatelet therapy for prevention of stroke recurrences and combined vascular events even after adjustment for confounding factors exclusively for patients with ICAS (p=0.017, 0.017, respectively), but not for those without (p=0.332, 0.674, respectively). Compared with aspirin alone, dual antiplatelet therapy significantly reduced the risk of stroke recurrences and combined vascular events (adjusted hazard ratio=0.33 [0.12-0.89], p=0.028; 0.33 [0.12-0.89], p=0.028, respectively) for patients with both ICAS and non-elevated Lp-PLA2 activity.