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, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
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.
Atherosclerosis. 2021 Sep;332:33-40. doi: 10.1016/j.atherosclerosis.2021.07.010. Epub 2021 Jul 30.
Osteopontin is implicated in atherosclerosis, and its expression is upregulated in response to brain injury. The aim of this study was to prospectively investigate the associations between plasma osteopontin levels and adverse clinical outcomes in ischemic stroke patients.
We measured baseline plasma osteopontin levels in 3545 ischemic stroke patients from the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS). The primary outcome was the composite outcome of death and major disability (modified Rankin scale score ≥3) at 1 year after ischemic stroke, and secondary outcomes included major disability, death, and the composite outcome of death and vascular events.
During 1 year of follow-up, patients in the fourth quartile of plasma osteopontin had the highest risks of primary outcome, major disability, death, and the composite outcome of death and vascular events. After multivariate adjustment, the odds ratios or hazard ratios (95 % confidence intervals) associated with each standard deviation increase in log-transformed osteopontin were 1.20 (1.09-1.33) for primary outcome, 1.11 (1.00-1.23) for major disability, 1.29 (1.10-1.52) for death, and 1.15 (1.01-1.30) for the composite outcome of death and vascular events. The addition of plasma osteopontin to conventional risk factors significantly improved the risk reclassification for the primary outcome (net reclassification improvement: 16.91%, p < 0.001; integrated discrimination improvement: 0.43%, p = 0.002).
Elevated plasma osteopontin levels at baseline were associated with increased risks of adverse clinical outcomes at 1 year after ischemic stroke, suggesting that osteopontin is a promising prognostic biomarker for ischemic stroke.
骨桥蛋白与动脉粥样硬化有关，其表达水平在脑损伤时上调。本研究旨在前瞻性研究缺血性脑卒中患者血浆骨桥蛋白水平与不良临床结局之间的关系。
我们在来自中国急性缺血性脑卒中抗高血压治疗试验（CATIS）的 3545 例缺血性脑卒中患者中测量了基线血浆骨桥蛋白水平。主要结局是缺血性脑卒中后 1 年时死亡和主要残疾（改良 Rankin 量表评分≥3）的复合结局，次要结局包括主要残疾、死亡和死亡与血管事件的复合结局。
在 1 年的随访期间，血浆骨桥蛋白第四四分位的患者发生主要结局、主要残疾、死亡和死亡与血管事件的复合结局的风险最高。经多变量调整后，log 转化的骨桥蛋白每增加 1 个标准差相关的优势比或风险比（95%置信区间）分别为 1.20（1.09-1.33）、1.11（1.00-1.23）、1.29（1.10-1.52）和 1.15（1.01-1.30）。将血浆骨桥蛋白加入常规危险因素显著改善了主要结局的风险再分类（净再分类改善：16.91%，p<0.001；综合判别改善：0.43%，p=0.002）。
基线时血浆骨桥蛋白水平升高与缺血性脑卒中后 1 年不良临床结局的风险增加相关，提示骨桥蛋白是缺血性脑卒中的一种有前途的预后生物标志物。
