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血浆桥粒芯糖蛋白 I 标志物与缺血性脑卒中后血管再发。

Plasma desmoplakin I biomarker of vascular recurrence after ischemic stroke.

机构信息

Cardiovascular Research Unit, Cardiology Department, Cardiovascular Institute, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.

出版信息

J Neurochem. 2012 Apr;121(2):314-25. doi: 10.1111/j.1471-4159.2012.07683.x. Epub 2012 Mar 13.

Abstract

Stroke patients have a high risk of vascular recurrence. Biomarkers related to vascular recurrence, however, remain to be identified. The aim of the study was to identify, through proteomic analysis, plasma biomarkers associated with vascular recurrence within one year after the first ischemic stroke. This is a substudy (n = 134) of a large prospective multicenter study of post-stroke patients with an ischemic stroke. Plasma samples were obtained at inclusion. Among the identified proteins, only plasma levels of desmoplakin I were associated with protection against a new vascular event (Odds ratio: 0.64; 95% CI: 0.46-0.89; p = 0.009) after adjustment for hypercholesterolemia, statins and previous atherothrombotic stroke subtype. A greater number of patients without vascular recurrence had been treated with statins within three months of the recent ischemic stroke. Only patients who had been taking statins for 3 months after the ischemic stroke and did not suffer vascular recurrence over a follow-up year, have higher levels of desmoplakin I at the time of inclusion (Odds ratio 0.49; 95% CI: 0.28-0.86; p = 0.013). Increased desmoplakin I levels, determined within 1-3 months of the first ischemic stroke, could be a biomarker for statin responsiveness against a new vascular event in post-ischemic stroke patients taking statins early (1-3 months) after the ischemic stroke.

摘要

中风患者血管再发的风险较高。然而,与血管再发相关的生物标志物仍有待确定。本研究旨在通过蛋白质组学分析,确定首次缺血性中风后一年内与血管再发相关的血浆生物标志物。这是一项大型前瞻性多中心中风后患者研究的子研究(n=134)。在纳入时采集了血浆样本。在所鉴定的蛋白质中,只有桥粒芯糖蛋白 I 的血浆水平与新血管事件的保护作用相关(优势比:0.64;95%可信区间:0.46-0.89;p=0.009),校正高胆固醇血症、他汀类药物和既往动脉粥样硬化血栓形成性中风亚型后。在最近的缺血性中风后 3 个月内,更多没有血管再发的患者接受了他汀类药物治疗。只有在缺血性中风后接受他汀类药物治疗 3 个月且在随访年内没有发生血管再发的患者,在纳入时桥粒芯糖蛋白 I 的水平更高(优势比 0.49;95%可信区间:0.28-0.86;p=0.013)。在首次缺血性中风后 1-3 个月内确定的桥粒芯糖蛋白 I 水平升高可能是他汀类药物反应性的生物标志物,用于预测在缺血性中风后早期(1-3 个月)开始服用他汀类药物的患者的新血管事件。

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