Paris Cardiovascular Research Center, University Paris Descartes, Sorbonne Paris Cité, UMR-S970, Paris, France.
Arterioscler Thromb Vasc Biol. 2013 Mar;33(3):659-66. doi: 10.1161/ATVBAHA.112.300109. Epub 2013 Jan 17.
To simultaneously evaluate 14 biomarkers from distinct biological pathways for risk prediction of ischemic stroke, including biomarkers of hemostasis, inflammation, and endothelial activation as well as chemokines and adipocytokines.
The Prospective Epidemiological Study on Myocardial Infarction (PRIME) is a cohort of 9771 healthy men 50 to 59 years of age who were followed up over 10 years. In a nested case-control study, 95 ischemic stroke cases were matched with 190 controls. After multivariable adjustment for traditional risk factors, fibrinogen (odds ratio [OR], 1.53; 95% confidence interval [CI], 1.03-2.28), E-selectin (OR, 1.76; 95% CI, 1.06-2.93), interferon-γ-inducible-protein-10 (OR, 1.72; 95% CI, 1.06-2.78), resistin (OR, 2.86; 95% CI, 1.30-6.27), and total adiponectin (OR, 1.82; 95% CI, 1.04-3.19) were significantly associated with ischemic stroke. Adding E-selectin and resistin to a traditional risk factor model significantly increased the area under the receiver-operating characteristic curve from 0.679 (95% CI, 0.612-0.745) to 0.785 and 0.788, respectively, and yielded a categorical net reclassification improvement of 29.9% (P=0.001) and 28.4% (P=0.002), respectively. Their simultaneous inclusion in the traditional risk factor model increased the area under the receiver-operating characteristic curve to 0.824 (95% CI, 0.770-0.877) and resulted in an net reclassification improvement of 41.4% (P<0.001). Results were confirmed when using continuous net reclassification improvement.
Among multiple biomarkers from distinct biological pathways, E-selectin and resistin provided incremental and additive value to traditional risk factors in predicting ischemic stroke.
同时评估来自不同生物学途径的 14 种生物标志物，以预测缺血性脑卒中的风险，这些生物标志物包括止血、炎症和血管内皮激活标志物以及趋化因子和脂肪细胞因子。
前瞻性心肌梗死研究（PRIME）是一项队列研究，共纳入 9771 名年龄在 50 至 59 岁之间的健康男性，随访时间超过 10 年。在一项巢式病例对照研究中，95 例缺血性脑卒中病例与 190 例对照相匹配。在对传统危险因素进行多变量调整后，纤维蛋白原（比值比[OR]，1.53；95%置信区间[CI]，1.03-2.28）、E-选择素（OR，1.76；95%CI，1.06-2.93）、干扰素-γ诱导蛋白-10（OR，1.72；95%CI，1.06-2.78）、抵抗素（OR，2.86；95%CI，1.30-6.27）和总脂联素（OR，1.82；95%CI，1.04-3.19）与缺血性脑卒中显著相关。将 E-选择素和抵抗素添加到传统危险因素模型中，分别使受试者工作特征曲线下面积从 0.679（95%CI，0.612-0.745）增加至 0.785 和 0.788，且分别使分类净重新分类改善率增加 29.9%（P=0.001）和 28.4%（P=0.002）。当将它们同时纳入传统危险因素模型中时，受试者工作特征曲线下面积增加至 0.824（95%CI，0.770-0.877），且使净重新分类改善率增加 41.4%（P<0.001）。当使用连续净重新分类改善率时，结果得到了证实。
在来自不同生物学途径的多种生物标志物中，E-选择素和抵抗素在预测缺血性脑卒中方面，为传统危险因素提供了额外的、可叠加的价值。
