School of Public Health, The University of Hong Kong, Hong Kong, China.
J Nutr Health Aging. 2012 Apr;16(4):383-8. doi: 10.1007/s12603-012-0048-6.
Whether isoflavone has any effect on recurrent cardiovascular events is unknown.
To investigate the relations between isoflavone intake and the risk of stroke recurrence.
We recruited 127 consecutive patients with prior history of atherothrombotic/ hemorrhagic stroke (mean age: 67 ± 11 years, 69% male) and prospectively followed up for a mean duration of 30 months. Stroke recurrence and major adverse cardiovascular events (MACE) were documented. Brachial flow-mediated dilatation (FMD) was measured using high-resolution ultrasound. Isoflavone intake was estimated using a validated food frequency questionnaire.
Median isoflavone intake was 6.9 (range: 2.1 - 14.5) mg/day. Isoflavone intake was independently associated with increased FMD (Pearson R=0.23, p=0.012). At 30 months, there were 10 stroke recurrence and 12 MACE. Kaplan-Meier analysis showed that patients with isoflavone intake higher than median value had significantly longer median stroke recurrence-free survival time (19.0 [range: 10.4 - 27.6] mth versus 5.0 [range: 4.1 - 5.9] mth, p=0.021) and MACE-free survival time (19.0 [range: 10.4 - 27.6] mth versus 4.0 [range: 2.4 - 5.6] mth, p=0.013). Using multivariate cox regression, higher isoflavone intake was an independent predictor for lower risk of stroke recurrence (hazards ratio 0.18 [95%CI: 0.03 - 0.95], risk reduction 82%, p=0.043) and MACE (hazards ratio 0.16 [95%CI: 0.03 - 0.84], risk reduction 84%, p=0.030).
Higher isoflavone intake in stroke patients was associated with prolonged recurrence-free survival, and reduced risk of stroke recurrence and MACE independent of baseline vascular function. Whether isoflavone may confer clinically significant secondary protection in stroke patients should be further investigated in a randomized controlled trial.
异黄酮是否对复发性心血管事件有影响尚不清楚。
研究异黄酮摄入与中风复发风险之间的关系。
我们招募了 127 例有动脉粥样硬化/出血性中风既往病史的连续患者（平均年龄：67±11 岁，69%为男性），并前瞻性随访平均 30 个月。记录中风复发和主要不良心血管事件（MACE）。使用高分辨率超声测量肱动脉血流介导的扩张（FMD）。异黄酮摄入量使用经过验证的食物频率问卷进行估计。
中位数异黄酮摄入量为 6.9（范围：2.1-14.5）mg/天。异黄酮摄入量与 FMD 增加独立相关（Pearson R=0.23，p=0.012）。30 个月时，有 10 例中风复发和 12 例 MACE。Kaplan-Meier 分析显示，异黄酮摄入量高于中位数的患者中风复发无事件生存时间中位数显著更长（19.0[范围：10.4-27.6] 月与 5.0[范围：4.1-5.9] 月，p=0.021）和 MACE 无事件生存时间中位数更长（19.0[范围：10.4-27.6] 月与 4.0[范围：2.4-5.6] 月，p=0.013）。使用多变量 Cox 回归，较高的异黄酮摄入量是中风复发风险较低的独立预测因素（风险比 0.18[95%CI：0.03-0.95]，风险降低 82%，p=0.043）和 MACE（风险比 0.16[95%CI：0.03-0.84]，风险降低 84%，p=0.030）。
中风患者较高的异黄酮摄入量与无复发生存时间延长相关，并降低中风复发和 MACE 的风险，独立于基线血管功能。异黄酮是否可能为中风患者提供临床上显著的二级保护，还需要进一步在随机对照试验中进行研究。
