Neurovascular Research Laboratory, Vall d'Hebron Hospital, Barcelona, Spain.
Neurovascular Unit, Stroke Unit, Department of Neurology, Hospital Clínico, Universitario de Valladolid, Valladolid, Spain.
Atherosclerosis. 2014 Mar;233(1):186-9. doi: 10.1016/j.atherosclerosis.2013.12.034. Epub 2014 Jan 8.
We prospectively examine the single and combined predictive value of biological and clinical markers in recurrent strokes related to intracranial atherosclerotic disease (ICAD).
In 73 ICAD first-ever stroke patients, ankle-brachial index (ABI) was assessed three months after TIA or stroke together with CRP, Lp-PLA2, ICAM-1, E-selectin and PAI-1 measurements. Appearance of new TIA/stroke was assessed every 6 months.
After a median follow-up of 22.4 months, 13 patients (17.8%) suffered a new stroke or TIA. Risk of new cerebrovascular events (CVEs) was associated with lowered ABI (p=0.011), baseline PAI-1>22.52 ng/ml (<0.001), E-selectin>24.75 ng/ml (p = 0.008) and ICAM-1>205 ng/ml (p = 0.029). The combination of PAI-1 with ABI or ESRS reclassified 55.4% (p<0.005) and 48.3% (p<0.05) of patients between low, high and very high-risk categories.
This tentative study shows that ABI and PAI-1 are associated with the risk of new CVEs in symptomatic ICAD patients, and their combination might improve identification of patients at higher risk.
我们前瞻性地检查了与颅内动脉粥样硬化性疾病（ICAD）相关的复发性卒中的生物和临床标志物的单一和联合预测价值。
在 73 例 ICAD 首发卒中患者中，在 TIA 或卒中后三个月评估踝臂指数（ABI），同时测量 CRP、Lp-PLA2、ICAM-1、E-选择素和 PAI-1。每 6 个月评估新 TIA/卒中的发生情况。
中位随访 22.4 个月后，13 名患者（17.8%）发生新的卒中或 TIA。新脑血管事件（CVEs）的风险与降低的 ABI（p=0.011）、基线 PAI-1>22.52ng/ml（<0.001）、E-选择素>24.75ng/ml（p=0.008）和 ICAM-1>205ng/ml（p=0.029）相关。PAI-1 与 ABI 或 ESRS 的联合将 55.4%（p<0.005）和 48.3%（p<0.05）的患者重新分类为低、高和极高风险类别。
这项初步研究表明，ABI 和 PAI-1 与症状性 ICAD 患者新 CVEs 的风险相关，它们的联合可能会提高对高风险患者的识别能力。
