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高敏C反应蛋白改变急性缺血性卒中或短暂性脑缺血发作患者V1导联P波终末电势相关的预后

High-Sensitivity C-Reactive Protein Modifies P-Wave Terminal Force in Lead V1-Associated Prognosis in Acute Ischemic Stroke or TIA Patients.

作者信息

Wu Yueyang, Lv Wei, Li Jiejie, Yang Xiaomeng, Meng Xia, Li Zixiao, Pan Yuesong, Jiang Yong, Yan Hongyi, Huang Xinying, Liu Liping, Zhao Xingquan, Wang Yilong, Li Hao, Wang Yongjun

机构信息

Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China.

China National Clinical Research Center for Neurological Diseases, Beijing 100070, China.

出版信息

J Clin Med. 2023 Mar 3;12(5):2031. doi: 10.3390/jcm12052031.

Abstract

Little is known about the role of high-sensitivity C-reactive protein (hsCRP) in the relationship between P-wave terminal force in lead V1 (PTFV1) and stroke prognosis. We aimed to investigate how hsCRP influences the effect of PTFV1 on ischemic stroke recurrence and mortality. In this study, patients enrolled in the Third China National Stroke Registry, which enrolled consecutive patients who had suffered an ischemic stroke or transient ischemic attack in China, were analyzed. After excluding patients with atrial fibrillation, 8271 patients with PTFV1 and hsCRP measurements were included in this analysis. Cox regression analyses were used to assess the association between PTFV1 and stroke prognosis according to different inflammation statuses stratified by an hsCRP level of 3 mg/L. A total of 216 (2.6%) patients died, and 715 (8.6%) patients experienced ischemic stroke recurrence within 1 year. In patients with hsCRP levels ≥ 3 mg/L, elevated PTFV1 was significantly associated with mortality (HR, 1.75; 95% CI, 1.05-2.92; = 0.03), while in those with hsCRP levels < 3 mg/L, such an association did not exist. In contrast, in patients with hsCRP levels < 3 mg/L and those with hsCRP levels ≥ 3 mg/L, elevated PTFV1 remained significantly associated with ischemic stroke recurrence. The predictive role of PTFV1 towards mortality but not ischemic stroke recurrence differed in terms of hsCRP levels.

摘要

关于高敏C反应蛋白(hsCRP)在V1导联P波终末电势(PTFV1)与卒中预后关系中的作用,目前所知甚少。我们旨在研究hsCRP如何影响PTFV1对缺血性卒中复发和死亡率的作用。在本研究中,对纳入第三届中国国家卒中登记研究的患者进行了分析,该研究纳入了在中国发生缺血性卒中或短暂性脑缺血发作的连续患者。在排除心房颤动患者后,本分析纳入了8271例有PTFV1和hsCRP测量值的患者。采用Cox回归分析,根据hsCRP水平3 mg/L分层的不同炎症状态,评估PTFV1与卒中预后之间的关联。共有216例(2.6%)患者死亡,715例(8.6%)患者在1年内发生缺血性卒中复发。在hsCRP水平≥3 mg/L的患者中,PTFV1升高与死亡率显著相关(HR,1.75;95%CI,1.05 - 2.92;P = 0.03),而在hsCRP水平<3 mg/L的患者中,不存在这种关联。相反,在hsCRP水平<3 mg/L和hsCRP水平≥3 mg/L的患者中,PTFV1升高与缺血性卒中复发仍显著相关。PTFV1对死亡率而非缺血性卒中复发的预测作用在hsCRP水平方面存在差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c54/10003915/b51ee09661af/jcm-12-02031-g001.jpg

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