Plasma CXCL12 levels as a predictor of future stroke.
Plasma CXCL12 levels as a predictor of future stroke.
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DOI：
10.1161/strokeaha.112.660878
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发表时间：
2012-12
期刊：
影响因子：
8.3
通讯作者：
Keeley EC
中科院分区：
文献类型：
--
作者：
Schutt RC;Burdick MD;Strieter RM;Mehrad B;Keeley EC
趋化因子配体CXCL 12在骨髓和包括脑内皮的其他组织中组成型表达，并负责调节骨髓祖细胞的运输。CXCL 12已被证明在缺血性中风的动物模型中发挥重要作用，但其在人类中风中的作用尚不清楚。本研究的目的是检验循环基线CXCL 12水平升高与随后卒中相关的假设。我们前瞻性地收集了接受选择性冠状动脉造影的连续患者的人口统计学和血管造影数据。在冠状动脉血管造影术之前，收集外周血样品用于随后的CXCL 12测量。一年中风风险使用Fragrance Risk Profile计算。在6个月和1年时进行临床随访。我们前瞻性地收集了接受选择性冠状动脉造影的连续患者的人口统计学和血管造影数据。在冠状动脉血管造影术之前，收集外周血样品用于随后的CXCL 12测量。一年中风风险使用Fragrance Risk Profile计算。在6个月和1年时进行临床随访。在入组的206例受试者中，10例（4.9%）在1年随访期间持续发生缺血性卒中。基线临床特征或血管造影结果无显著差异。然而，与未发生缺血性卒中的患者相比，发生缺血性卒中的患者的中位CXCL 12水平显著更高（10856 pg/mL vs 2241 pg/mL，p=0.007）。基线CXCL 12水平≥ 10，421 pg/mL的受试者与基线CXCL 12水平<10，421 pg/mL的受试者之间的卒中时间分布显著不同（对数秩p<0.001）。加权考克斯比例风险模型显示基线CXCL 12水平≥ 10，421 pg/mL与随访时缺血性卒中显著相关（HR 15.29; 95% CI 3.05 - 76.71）。血浆CXCL 12水平可能代表未来缺血性卒中的新生物标志物。
The chemokine ligand CXCL12 is constitutively expressed in the bone marrow and other tissues including the brain endothelium and is responsible for regulating the trafficking of bone marrow progenitor cells. CXCL12 has been shown to play a significant role in animal models of ischemic stroke but its role in human stroke is unclear. The aim of this study was to test the hypothesis that elevated circulating baseline CXCL12 levels are associated with subsequent stroke. We prospectively collected demographic and angiographic data from consecutive patients referred for elective coronary angiography. Prior to coronary angiography a peripheral blood sample was collected for subsequent measurement of CXCL12. One-year stroke risk was calculated using the Framingham Risk Profile. Clinical follow-up was performed at 6 months and one year. We prospectively collected demographic and angiographic data from consecutive patients referred for elective coronary angiography. Prior to coronary angiography a peripheral blood sample was collected for subsequent measurement of CXCL12. One-year stroke risk was calculated using the Framingham Risk Profile. Clinical follow-up was performed at 6 months and one year. Of 206 subjects enrolled, 10 (4.9%) sustained an ischemic stroke over the one year follow-up. There were no significant differences in baseline clinical characteristics or angiographic findings. However, median CXCL12 levels were significantly higher in those who sustained an ischemic stroke compared to those who did not (10856 pg/mL vs 2241 pg/mL, p=0.007). The time to stroke distribution between subjects with baseline CXCL12 levels ≥ 10,421 pg/mL and those with baseline CXCL12 levels <10,421 pg/mL were significantly different (logrank p<0.001). The weighted Cox proportional hazard model demonstrated that baseline CXCL12 levels ≥ 10,421 pg/mL were significantly associated with ischemic stroke at follow-up (HR 15.29; 95% CI 3.05 to 76.71). Plasma CXCL12 levels may represent a novel biomarker of future ischemic stroke.