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》

Glycated Albumin Predicts the Effect of Dual and Single Antiplatelet Therapy on Recurrent Stroke

第一作者：jiejie li,yilong wang

通讯作者：yongjun wang

stroke prognosis clopidogrel glycated albumin

基本信息

2015-03-03

已发表文章

发表杂志：neurology

发表类型: Original Contributions

影响因子(IF): 9.91

PMID: 25740863 Pubmed原文链接 全文下载

主要研究背景及目的

To determine the relationship of glycated albumin (GA) and the recurrence of stroke in patients on either dual or single antiplatelet therapy

方法

The Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events trial randomized minor ischemic stroke or TIA patients to antiplatelet therapy of clopidogrel plus aspirin or aspirin alone. A subgroup of 3,044 consecutive patients with baseline GA levels from 73 (64%) prespecified clinical sites was analyzed. Patients were categorized into 2 groups based on GA level of 15.5%, the cut point for development of diabetes. The primary outcome was stroke recurrence during 90-day follow-up. Cox proportional hazards models were used to assess the interaction of GA with randomized antiplatelet therapy on their risk of recurrent stroke.

结论

GA could be a potential biomarker to predict the effects of dual and single antiplatelet therapy in patients with minor stroke or TIA

主要结果

Significant interaction of GA levels with the 2 antiplatelet therapy groups was found after adjustment for age, sex, and other conventional confounding factors (p 5 0.009). The interaction remained consistent after further adjustment for history of diabetes (p 5 0.010). In patients with lower GA level, stroke occurred in 5.5% of patients in the clopidogrel–aspirin group, and 12.7% in the aspirin group (adjusted hazard ratio [HR] 0.40; 95%confidence interval [CI] 0.26–0.61; p ,0.001). Furthermore, in patients with elevated GA level, stroke occurred in 9.2% of patients in the clopidogrel–aspirin group, and 11.4%in the aspirin group (adjusted HR 0.79; 95% CI 0.60–1.05; p 5 0.103).