动脉高血压患者中风后的C反应蛋白

C-reactive protein after stroke in arterial hypertension.

作者信息

Berezin Alexander E, Lisovaya Oxana A

机构信息

Internal Medicine Department, Zaporozhye State Medical University, Zaporozhye, Ukraine

Cardiology Department, District Hospital #6, Zaporozhye State Medical University, Zaporozhye, Ukraine.

出版信息

Asian Cardiovasc Thorac Ann. 2014 Jun;22(5):551-7. doi: 10.1177/0218492313501163. Epub 2013 Oct 29.

DOI:10.1177/0218492313501163

PMID:24867029

Abstract

OBJECTIVE

To evaluate the relationship between plasma high-sensitivity C-reactive protein level and the risk of recurrent coronary and cerebral ischemic events after ischemic stroke in patients with arterial hypertension.

METHODS

102 patients with mild-to-moderate arterial hypertension (67 male, aged 56-68 years) were enrolled in the study. Serum high-sensitivity C-reactive protein was determined on study entry only. Clinical interviews were performed every 3 months during 1 year after blood sampling. Clinical events included confirmed ischemic stroke or transient ischemic attack, coronary ischemic events, sudden death, diabetes mellitus, and all cardiovascular events including chronic heart failure and hospitalization.

RESULTS

Patients in the highest quartile of high-sensitivity C-reactive protein levels had a significantly higher adjusted odds ratio for clinical events compared to those in the first quartile (odds ratio = 7.46, 95% confidence interval: 1.55-19.6, p = 0.001). A receiver operating characteristic curve detected a plasma high-sensitivity C-reactive protein cutoff level of 5.58 mg·L(-1) (76.7% sensitivity, 80.3% specificity). A Cox regression model identified high-sensitivity C-reactive protein >5.58 mg·L(-1) as an independent predictor of further cardiovascular events (hazard ratio = 7.14, 95% confidence interval: 1.15-12.6, p = 0.009).

CONCLUSION

We suggest that high-sensitivity C-reactive protein levels >5.58 mg·L(-1) strongly predict increased risk of cumulative cardiovascular events after ischemic stroke in hypertensive patients.

摘要

目的

评估动脉高血压患者缺血性卒中后血浆高敏C反应蛋白水平与冠状动脉和脑缺血性事件复发风险之间的关系。

方法

102例轻至中度动脉高血压患者（67例男性，年龄56 - 68岁）纳入本研究。仅在研究入组时测定血清高敏C反应蛋白。采血后1年内每3个月进行一次临床访谈。临床事件包括确诊的缺血性卒中或短暂性脑缺血发作、冠状动脉缺血事件、猝死、糖尿病以及所有心血管事件，包括慢性心力衰竭和住院治疗。

结果

高敏C反应蛋白水平处于最高四分位数的患者与处于第一四分位数的患者相比，临床事件的调整优势比显著更高（优势比 = 7.46，95%置信区间：1.55 - 19.6，p = 0.001）。受试者工作特征曲线检测到血浆高敏C反应蛋白的截断水平为5.58 mg·L⁻¹（灵敏度76.7%，特异度80.3%）。Cox回归模型确定高敏C反应蛋白>5.58 mg·L⁻¹是进一步心血管事件的独立预测因子（风险比 = 7.14，95%置信区间：1.15 - 12.6，p = 0.009）。