From the Clinical Research Unit, Medicine, Skåne University Hospital Malmö, Malmö, Sweden (M.P., G.Ö., O.M.); and Department of Clinical Sciences Malmö, Lund University, Lund, Sweden (M.P., G.Ö., G.S., V.H., O.M., B.H., G.E.).
Stroke. 2014 Jan;45(1):18-23. doi: 10.1161/STROKEAHA.113.003305. Epub 2013 Nov 19.
Recent studies indicate that the urokinase system could have an important role in atherogenesis and plaque rupture. The relationships among the soluble urokinase plasminogen activator receptor (suPAR), carotid plaque, and incidence of ischemic stroke and coronary artery disease (CAD) events were studied in a prospective cohort.
Occurrence of carotid plaque and plasma levels of suPAR were assessed in 5166 men and women, aged 45 to 68 years, participating in the Malmö Diet and Cancer study. Incidences of ischemic stroke and CAD were monitored during a mean follow-up of 15 years.
Subjects with carotid plaque had significantly higher levels of suPAR compared with those without carotid plaque. suPAR was associated with increased incidence of ischemic stroke (hazard ratio [HR] for third versus first tertile, 1.50; 95% confidence interval [CI], 1.06-2.11) and CAD (HR, 1.55; 95% CI, 1.13-2.13) after adjustment for risk factors. The risk factor-adjusted HR for ischemic stroke was 2.21 (95% CI, 1.52-3.22) in subjects with carotid plaque and high suPAR (ie, third tertile) and 1.51 (95% CI, 1.05-2.17) in subjects with carotid plaque and low suPAR compared with those without carotid plaque and low suPAR (reference). High levels of suPAR significantly increased the risk of ischemic stroke and CAD in subjects with carotid plaque.
suPAR is associated with increased occurrence of carotid plaque and increased incidence of ischemic stroke and CAD. Presence of both elevated levels of suPAR and carotid plaque increases the risk of ischemic stroke in an additive way.
近期研究表明尿激酶系统在动脉粥样硬化和斑块破裂中可能具有重要作用。本前瞻性队列研究旨在探讨可溶性尿激酶型纤溶酶原激活物受体（suPAR）、颈动脉斑块与缺血性卒中和冠心病（CAD）事件发生之间的关系。
在年龄 45-68 岁的 5166 名男性和女性中，通过 Malmö Diet and Cancer 研究评估颈动脉斑块的发生情况和 suPAR 的血浆水平。平均随访 15 年后监测缺血性卒中和 CAD 的发生情况。
有颈动脉斑块的受试者的 suPAR 水平明显高于无颈动脉斑块的受试者。suPAR 与缺血性卒中和 CAD 的发生率增加相关（第三与第一 tertile 相比的风险比 [HR]，1.50；95%置信区间 [CI]，1.06-2.11；HR，1.55；95% CI，1.13-2.13），校正危险因素后。在颈动脉斑块和 suPAR 水平较高（即第三 tertile）的受试者中，缺血性卒中的校正风险比（HR）为 2.21（95% CI，1.52-3.22），在颈动脉斑块和 suPAR 水平较低的受试者中，HR 为 1.51（95% CI，1.05-2.17），与无颈动脉斑块和 suPAR 水平较低的受试者相比（参考）。suPAR 水平较高显著增加了颈动脉斑块患者缺血性卒中和 CAD 的发病风险。
suPAR 与颈动脉斑块的发生、缺血性卒中和 CAD 的发生率增加相关。suPAR 水平升高和颈动脉斑块的存在以累加的方式增加缺血性卒中的风险。
