High-Sensitive C-Reactive Protein Predicts Recurrent Stroke and Poor Functional Outcome Subanalysis of the Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events Trial
High-Sensitive C-Reactive Protein Predicts Recurrent Stroke and Poor Functional Outcome Subanalysis of the Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events Trial
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DOI：
10.1161/strokeaha.116.012901
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发表时间：
2016-08-01
期刊：
影响因子：
8.3
通讯作者：
Wang, Yongjun
中科院分区：
文献类型：
--
作者：
Li, Jiejie;Zhao, Xingquan;Wang, Yongjun
背景和目的--轻度卒中和短暂性脑缺血发作是常见的疾病，随后致残性卒中的发生率很高。我们旨在探讨高敏C反应蛋白(HsCRP)在预测卒中复发和不良功能结局中的作用。方法：在氯吡格雷治疗高危患者的急性非致残性脑血管事件(Chance)试验中，来自73个预先指定的中心(%)的3044名(59%)患者接受了hsCRP水平的检测。主要结果是90天内的任何中风。次要结果包括合并血管事件和依赖或死亡，定义为90天时改良Rankin评分2~6分，以及1年随访期间的新血管事件。用COX比例风险模型和Logistic回归模型分析超敏C反应蛋白与再发卒中和功能预后的关系。结果：32%的研究人群观察到超敏C反应蛋白升高(>；3.0 mg/L)。与hsCRP携带者相比，hsCRP+gt；3 mg/gt；患者再发卒中(调整风险比1.46；95%可信区间1.08-1.98；P=0.039)、缺血性卒中和合并血管事件的风险增加，功能预后较差(调整优势比1.68；95%可信区间1.22-2.32；P=0.002)。
Background and Purpose-Minor stroke and transient ischemic attack are common disorders with high rate of subsequent disabling stroke. We aim to investigate the role of high-sensitive C-reactive protein (hsCRP) in predicting recurrent stroke and poor functional outcome.Methods-In the Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events (CHANCE) trial, 3044 (59%) consecutive patients from 73 (64%) prespecified centers had hsCRP levels measured. The primary outcome was any stroke within 90 days. The secondary outcome included combined vascular events and dependence or death defined as modified Rankin Scale score of 2 to 6 at 90 days and a new vascular event during 1-year follow-up. The associations of hsCRP with recurrent stroke and functional outcome were analyzed by using Cox proportional hazards and logistic regression models.Results-Elevated hsCRP (>3.0 mg/L) was observed in 32% of the study population. Patients with hsCRP >3 mg/L had an increased risk of recurrent stroke (adjusted hazard ratio, 1.46; 95% confidence interval, 1.08-1.98; P=0.039), ischemic stroke and combined vascular events, and poor functional outcome (adjusted odds ratio, 1.68; 95% confidence interval, 1.22-2.32; P=0.002) compared with those with hsCRP