Postacute C-reactive protein levels are elevated in cervical artery dissection
Postacute C-reactive protein levels are elevated in cervical artery dissection
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DOI：
10.1161/01.str.0000158911.74006.d6
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发表时间：
2005-04-01
期刊：
影响因子：
8.3
通讯作者：
Lichy, C
中科院分区：
文献类型：
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作者：
Genius, J;Dong-Si, T;Lichy, C
背景和目的-C反应蛋白（CRP）与大多数老年人的动脉粥样硬化和卒中有关。我们检测了CRP升高是否也与自发性颈动脉夹层（CAD）和隐源性卒中有关。方法：我们调查了62例年龄< 60岁的大动脉粥样硬化导致脑缺血患者的高敏CRP水平（LAA; n = 21）、CAD（n = 21）或隐源性病因（n = 20）> 9个月前，以及在54个性别和年龄匹配的人群对照中。采用受试者工作特征曲线确定CRP的最佳分界值（0.54 [ 0.33 - 0.84]中位数，四分位距mg/L）（2.59 [ 0.56 - 3.99] mg/L; P < 0.001）和CAD患者（2.37 [ 0.57 - 4.78] mg/L; P = 0.0013），但不明病因患者（0.74 [0.14 - 7.86] mg/L）则无。CRP水平高于0.71 mg/L的临界水平与前CAD（P = 0.005），但不与前LAA调整后的年龄，性别和传统的危险因素。结论-我们的研究结果强烈表明，CRP与CAD，独立于传统的危险因素，炎症机制可能在其发病机制中发挥作用。这一发现应该得到更大规模研究的证实。
Background and Purpose - C-reactive protein (CRP) is associated with atherogenesis and stroke in mostly elderly subjects. We tested whether elevated CRP may also be linked to spontaneous cervical artery dissection ( CAD) and cryptogenic stroke.Methods - We investigated high-sensitivity CRP levels in 62 patients < 60 years of age experiencing cerebral ischemia resulting from large artery atherosclerosis (LAA; n = 21), CAD ( n = 21), or cryptogenic etiology ( n = 20) > 9 months ago, and in 54 sex- and age-matched population controls. Receiver operating characteristic curve was used to identify the best CRP cutoff level for dichotomization.Results - CRP was elevated above control levels (0.54 [ 0.33 to 0.84] median, interquartile range mg/L) in patients with LAA (2.59 [ 0.56 to 3.99] mg/L; P < 0.001) and with CAD (2.37 [ 0.57 to 4.78] mg/L; P = 0.0013) but not in patients with cryptogenic etiology ( 0.74 [0.14 to 7.86] mg/L). CRP levels above the cutoff level of 0.71 mg/L were independently associated with former CAD ( P = 0.005) but not with former LAA after adjustment for age, gender, and conventional risk factors.Conclusion - Our results strongly suggest that CRP is associated with CAD, independent from conventional risk factors, and that inflammatory mechanisms may play a role in its pathogenesis. This finding should be confirmed by larger studies.