Liu Yang, Guo Daoxia, Wang Aili, Yang Jingyuan, Zhu Zhengbao, Xu Tan, Zhong Chongke, Peng Hao, Chen Jing, Zhou Yafeng, Zhang Yonghong, He Jiang
Department of Cardiology, First Affiliated Hospital of Soochow University, Suzhou, China; Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China.
Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China.
Clin Chim Acta. 2020 Dec;511:33-39. doi: 10.1016/j.cca.2020.09.020. Epub 2020 Sep 25.
N-terminal pro-brain natriuretic peptide (NT-proBNP) and galectin-3 are important biomarkers related to ischemic stroke. However, the predictive value of the combination of them has not been examined in previous studies.
The aim of this study was to investigate the combined effect of NT-proBNP and galectin-3 on clinical outcomes in ischemic stroke patients.
A total of 2694 patients (63.62% males; mean age = 62.4 in admission) with serum NT-proBNP and galectin-3 measured simultaneously were included in this study. The primary outcome was composite outcome of death or major disability 1 year after stroke onset. Secondary outcomes were separately death, major disability, vascular events and the composite outcome of vascular events or death. The participants were divided into 4 groups according to NT-proBNP and galectin-3. Odd ratios (ORs; for nonevent outcome without time variables: primary outcome, major disability) or hazard ratios (HRs; for event outcome with time variables: death, vascular events, and the composite outcome of vascular events or death) were calculated to assess the association of NT-proBNP and galectin-3 status with adverse outcomes.
At the 1-year follow-up, 589 patients experienced a primary outcome after stroke onset. After adjustment for potential confounders, high NT-proBNP/high galectin-3 group were associated with increased risks of primary outcome (OR: 1.43; 95% confidence interval [CI], 1.02-2.00; P value = 0.039), death (HR: 2.74; 95% CI, 1.42-5.29; P value = 0.003), and the composite outcome of vascular events or death (HR: 1.66; 95% CI, 1.06-2.58; P value = 0.026). Statistical tests for interactions between the 4 groups and primary outcome or death were not significant (all P interaction > 0.05).
Simultaneously increased NT-proBNP and galectin-3 significantly increased the risk of poor clinical outcomes 1 year after ischemic stroke. Using NT-proBNP and galectin-3 together can result in an accurate prediction of ischemic stroke prognosis.
N端前脑钠肽（NT-proBNP）和半乳糖凝集素-3是与缺血性中风相关的重要生物标志物。然而，此前的研究尚未考察二者联合使用时的预测价值。
本研究旨在探讨NT-proBNP和半乳糖凝集素-3对缺血性中风患者临床预后的联合影响。
本研究纳入了2694例同时检测了血清NT-proBNP和半乳糖凝集素-3的患者（男性占63.62%；入院时平均年龄为62.4岁）。主要结局为中风发作后1年的死亡或严重残疾复合结局。次要结局分别为死亡、严重残疾、血管事件以及血管事件或死亡的复合结局。根据NT-proBNP和半乳糖凝集素-3将参与者分为4组。计算比值比（OR；用于无时间变量的非事件结局：主要结局、严重残疾）或风险比（HR；用于有时间变量的事件结局：死亡、血管事件以及血管事件或死亡的复合结局），以评估NT-proBNP和半乳糖凝集素-3状态与不良结局之间的关联。
在1年的随访中，589例患者在中风发作后出现了主要结局。在对潜在混杂因素进行调整后，高NT-proBNP/高半乳糖凝集素-3组发生主要结局的风险增加（OR：1.43；95%置信区间[CI]，1.02 - 2.00；P值 = 0.039）、死亡风险增加（HR：2.74；95% CI，1.42 - 5.29；P值 = 0.003），以及血管事件或死亡的复合结局风险增加（HR：1.66；95% CI，1.06 - 2.58；P值 = 0.026）。4组与主要结局或死亡之间的交互作用的统计学检验无显著性差异（所有P交互作用 > 0.05）。
缺血性中风后1年，NT-proBNP和半乳糖凝集素-3同时升高会显著增加不良临床结局的风险。联合使用NT-proBNP和半乳糖凝集素-3能够准确预测缺血性中风的预后。
