Soluble CD40L Is a Useful Marker to Predict Future Strokes in Patients With Minor Stroke and Transient Ischemic Attack
Soluble CD40L Is a Useful Marker to Predict Future Strokes in Patients With Minor Stroke and Transient Ischemic Attack
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可溶性 CD40L 是预测轻微中风和短暂性脑缺血发作患者未来中风的有用标记。
DOI：
10.1161/strokeaha.115.008685
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发表时间：
2015-07-01
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;Wang, Yilong;Wang, Yongjun
背景与目的：血清可溶性CD40配体(SCD40L)水平升高与心血管事件有关，但sCD40L在预测卒中复发中的作用尚不清楚。方法对3044例入选氯吡格雷高危患者的急性非致残性脑血管事件(Chance)试验患者的基线sCD40L水平进行检测。结果调整传统混杂因素后，sCD40L水平位于前三位的患者再发卒中的危险性较位于后三位的患者高(风险比为1.49；95%可信区间为1.11~2.00；P=0.008)。同时升高sCD40L和高敏C反应蛋白水平的患者也增加了复发中风的风险(风险比1.81；95%可信区间1.23-2.68；P=0.003)。结论sCD40L水平升高独立地预测轻微中风和短暂性脑缺血发作患者的复发中风。临床试验注册网址：http://www.clinicaltrials.gov.唯一标识：NCT00979589。
Background and Purpose Elevated soluble CD40 ligand (sCD40L) was shown to be related to cardiovascular events, but the role of sCD40L in predicting recurrent stroke remains unclear.Methods Baseline sCD40L levels were measured in 3044 consecutive patients with acute minor stroke and transient ischemic attack, who had previously been enrolled in the Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events (CHANCE) trial. Cox proportional-hazards model was used to assess the association of sCD40L with recurrent stroke.Results Patients in the top tertile of sCD40L levels had increased risk of recurrent stroke comparing with those in the bottom tertile, after adjusted for conventional confounding factors (hazard ratio, 1.49; 95% confidence interval, 1.11-2.00; P=0.008). The patients with elevated levels of both sCD40L and high-sensitive C-reactive protein also had increased risk of recurrent stroke (hazard ratio, 1.81; 95% confidence interval, 1.23-2.68; P=0.003).Conclusions Elevated sCD40L levels independently predict recurrent stroke in patients with minor stroke and transient ischemic attack.Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00979589.