Tissue inhibitor metalloproteinase-1 and clinical outcomes after acute ischemic stroke
Tissue inhibitor metalloproteinase-1 and clinical outcomes after acute ischemic stroke
复制标题
组织抑制剂金属蛋白酶-1 与急性缺血性卒中后的临床结果
DOI：
10.1212/wnl.0000000000008389
复制
发表时间：
2019-09
期刊：
影响因子：
9.9
通讯作者：
Zhang Y
中科院分区：
文献类型：
--
作者：
Zhong C;Wang G;Xu T;Zhu Z;Guo D;Zheng X;Wang A;Bu X;Peng H;Chen J;Xu T;Peng Y;Li Q;Ju Z;Geng D;He J;Zhang Y
目的前瞻性探讨急性缺血性卒中患者血清组织抑制物金属蛋白酶-1(TIMP-1)水平与临床转归的关系。方法资料来源于中国抗高血压治疗急性缺血性卒中的临床试验。对3342名参与者进行了基线血清TIMP-1浓度测定。主要结果是缺血性卒中后3个月死亡和主要残疾的组合(改良朗金评分≥3)，次要结果包括主要残疾、死亡和血管事件。结果共有843人(25.2%)在3个月内发生重大残疾或死亡。在调整了年龄、性别、入院NIH卒中评分和其他重要协变量后，1-SD(0.17 ng/mL)较高LOG-TIMP-1的优势比或危险比(95%可信区间)：主要结果为1.17(1.06-1.29)，严重残疾为1.13(1.02-1.25)，死亡为1.49(1.19-1.87)，死亡和血管事件的综合结果为1.34(1.11-1.62)。在传统危险因素模型中加入血清TIMP-1显著改善了对主要结果的风险预测(净重分类指数9.0%，p=0.02；综合判别度改善0.2%，p=0.03)。同时具有较高的TIMP-1和基质金属蛋白酶-9水平的参与者在所有研究结果中风险最高。结论TIMP-1水平升高与急性缺血性卒中后死亡和主要残疾风险增加相关。我们的研究结果支持细胞外基质生物标记物在急性缺血性卒中后的重要预后作用。
Objective To prospectively investigate the relationships between serum tissue inhibitor metalloproteinase-1 (TIMP-1) and clinical outcomes in patients with acute ischemic stroke. Methods We derived data from the China Antihypertensive Trial in Acute Ischemic Stroke. Baseline serum TIMP-1 concentrations were measured in 3,342 participants. The primary outcome was the combination of death and major disability (modified Rankin Scale score ≥3) at 3 months after ischemic stroke, and secondary outcomes included major disability, death, and vascular events. Results A total of 843 participants (25.2%) experienced major disability or died within 3 months. After adjustment for age, sex, admission NIH Stroke Scale score, and other important covariates, odds ratios or hazard ratios (95% confidence intervals) of 1-SD (0.17 ng/mL) higher log-TIMP-1 were 1.17 (1.06–1.29) for the primary outcome, 1.13 (1.02–1.25) for major disability, 1.49 (1.19–1.87) for death, and 1.34 (1.11–1.62) for the composite outcome of death and vascular events. The addition of serum TIMP-1 to conventional risk factors model significantly improved risk prediction of the primary outcome (net reclassification index 9.0%, p = 0.02; integrated discrimination improvement 0.2%, p = 0.03). Participants with both higher TIMP-1 and matrix metalloproteinase-9 levels simultaneously had the highest risk of all study outcomes. Conclusions Higher TIMP-1 levels were associated with increased risk of mortality and major disability after acute ischemic stroke. Our findings provided evidence supporting the important prognostic role of extracellular matrix biomarkers after acute ischemic stroke.
登录
查看更多内容
影响因子：
8.3
作者：
X. Wang;F. Barone;R. F. White;G. Feuerstein
通讯作者：
X. Wang;F. Barone;R. F. White;G. Feuerstein
影响因子：
2
作者：
DURRLEMAN, S;SIMON, R
通讯作者：
SIMON, R
影响因子：
4.9
作者：
M. Zureik;J. Beaudeux;D. Courbon;A. Benetos;P. Ducimetiere
通讯作者：
M. Zureik;J. Beaudeux;D. Courbon;A. Benetos;P. Ducimetiere
影响因子：
39.3
作者：
LaRocca, Gina;Aspelund, Thor;Arai, Andrew E.
通讯作者：
Arai, Andrew E.
影响因子：
37.8
作者：
Ahmed, SH;Clark, LL;Zile, MR
通讯作者：
Zile, MR