Jurin Ivana, Paić Frane, Bulimbašić Stela, Rudež Igor, Đerek Lovorka, Jurin Hrvoje, Knežević Aleksandar, Starcevic Boris, Ajduk Marko
Department of Cardiovascular Diseases, University Hospital Dubrava, Avenija Gojka Šuška 6, 10 000 Zagreb, Croatia.
Laboratory for Epigenetics and Molecular medicine, Department of Biology and Medical Genetics, School of Medicine, University of Zagreb, Šalata.
Heart Surg Forum. 2018 Nov 13;21(6):E448-E463. doi: 10.1532/hsf.2071.
ses of ischemic stroke. The risk of ischemic stroke increases with the degree of carotid stenosis and plaque vulnerability. The aim of this study was to investigate the association of circulating and plaque resistin levels with plaque vulnerability and ischemic stroke events in patients with moderate- to high-grade carotid artery stenosis.
40 patients with ischemic stroke events and 38 neurologically asymptomatic patients scheduled for carotid endarterectomy were recruited for this study. Fasting blood samples for laboratory analysis were collected preoperatively and serum resistin levels were measured by enzyme-linked immunosorbent assays. Carotid endarterectomy specimens were analyzed according to the gold-standard procedure of histological classification. Plaque resistin expression was determined by standard immunohistochemical procedure.
Serum resistin levels and resistin plaque expression were found to be significantly higher in subjects with unstable carotid plaque (P < .001) while significantly higher serum resistin levels were also present in patients with ischemic stroke events (P < .001). In univariate stepwise logistic regression analysis, higher serum resistin levels were significantly associated with plaque instability (OR 2.223, 95% CI 1.488-3.320, P < .0001) and ischemic stroke events (OR 1.237, 95% CI 1.079-1.420, P = .002). There was also a significant association between higher serum and plaque resistin expression (OR 1.663, 95% CI1.332-2.077, P < .0001). These associations remained significant in all models of multivariate logistic regression analysis. High serum and plaque resistin levels were also significantly associated with specific histological features of plaque instability.
The results suggests that serum resistin levels may be used as a potential biomarker of plaque vulnerability and ischemic stroke events in patients with moderate- to high-grade carotid artery stenosis and highlight the possible relationship that plaque resistin expression has with histological features of plaque vulnerability.
缺血性中风的情况。缺血性中风的风险随着颈动脉狭窄程度和斑块易损性的增加而升高。本研究的目的是调查中度至高度颈动脉狭窄患者循环和斑块抵抗素水平与斑块易损性及缺血性中风事件之间的关联。
本研究招募了40例发生缺血性中风事件的患者以及38例计划接受颈动脉内膜切除术的无症状神经学患者。术前采集空腹血样用于实验室分析,通过酶联免疫吸附测定法测量血清抵抗素水平。根据组织学分类的金标准程序对颈动脉内膜切除术标本进行分析。通过标准免疫组织化学程序测定斑块抵抗素表达。
发现不稳定颈动脉斑块患者的血清抵抗素水平和抵抗素斑块表达显著更高(P <.001),而发生缺血性中风事件的患者血清抵抗素水平也显著更高(P <.001)。在单变量逐步逻辑回归分析中,较高的血清抵抗素水平与斑块不稳定性显著相关(比值比2.223,95%置信区间1.488 - 3.320,P <.0001)以及缺血性中风事件(比值比1.237,95%置信区间1.079 - 1.420,P =.002)。血清和斑块抵抗素表达较高之间也存在显著关联(比值比1.663,95%置信区间1.332 - 2.077,P <.0001)。在多变量逻辑回归分析的所有模型中,这些关联仍然显著。高血清和斑块抵抗素水平也与斑块不稳定性的特定组织学特征显著相关。
结果表明,血清抵抗素水平可能用作中度至高度颈动脉狭窄患者斑块易损性和缺血性中风事件的潜在生物标志物,并突出了斑块抵抗素表达与斑块易损性组织学特征之间可能的关系。