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活化蛋白C抵抗并不增加卒中患者复发性卒中和死亡风险。

Activated Protein C Resistance Does Not Increase Risk for Recurrent Stroke or Death in Stroke Patients.

作者信息

Thaler Markus Alexander, Feurer Regina, Thaler Christoph, Sonntag Natalie, Schleef Michael, Rondak Ina-Christine, Poppert Holger

机构信息

Institut für Klinische Chemie und Pathobiochemie, Klinikum rechts der Isar der Technischen Universität München, München, Germany.

Neurologische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, München, Germany.

出版信息

PLoS One. 2016 Aug 10;11(8):e0160382. doi: 10.1371/journal.pone.0160382. eCollection 2016.

DOI:10.1371/journal.pone.0160382
PMID:27508300
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4980060/
Abstract

BACKGROUND

Activated protein C (APC) resistance is the most common inherited prothrombotic disorder. The role of APC resistance in ischemic stroke is controversially discussed.

OBJECTIVES

The aim of this single center follow up study was to investigate the effect of APC resistance on stroke recurrence and survival in stroke patients.

PATIENTS/METHODS: We retrospectively identified 966 patients who had had an ischemic stroke or transitory ischemic attack (TIA) and in whom laboratory tests for APC resistance had been conducted. These patients were contacted to determine the primary outcomes of recurrent ischemic stroke or death.

RESULTS

A total of 858 patients with an average follow up time of 8.48 years were included. APC resistance did not influence cumulative incidence functions for stroke free and total survival. In multivariate analyses, crude and adjusted hazard ratios for recurrent stroke as well as for death where not significantly increased in patients with APC resistance. This also applies to the subgroups of young patients, patients with cryptogenic stroke and patients with atrial fibrillation.

CONCLUSION

APC-resistance is not a risk factor for subsequent stroke or death in patients with a first ischemic stroke or TIA. Testing for APC-resistance in stroke patients therefore cannot be routinely recommended.

摘要

背景

活化蛋白C（APC）抵抗是最常见的遗传性血栓前状态疾病。APC抵抗在缺血性卒中中的作用存在争议。

目的

本单中心随访研究旨在探讨APC抵抗对卒中患者卒中复发和生存的影响。

患者/方法：我们回顾性纳入了966例曾发生缺血性卒中或短暂性脑缺血发作（TIA）且进行了APC抵抗实验室检测的患者。联系这些患者以确定复发性缺血性卒中和死亡的主要结局。

结果

共纳入858例患者，平均随访时间为8.48年。APC抵抗不影响无卒中累积发生率和总生存率。在多变量分析中，APC抵抗患者复发性卒中和死亡的粗风险比及校正风险比均未显著增加。这也适用于年轻患者、隐源性卒中患者和房颤患者亚组。

结论

APC抵抗不是首次缺血性卒中和TIA患者后续卒中或死亡的危险因素。因此，不建议对卒中患者常规检测APC抵抗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e34f/4980060/1398bef81c3e/pone.0160382.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e34f/4980060/1398bef81c3e/pone.0160382.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e34f/4980060/1398bef81c3e/pone.0160382.g001.jpg

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本文引用的文献

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Factor V Leiden does not have a role in cryptogenic ischemic stroke among Iranian young adults.凝血因子V莱顿突变在伊朗年轻成年人的不明原因缺血性卒中中不起作用。
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