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首页> 外文期刊>Journal of atherosclerosis and thrombosis. >Reduction in High-Sensitivity C-Reactive Protein Levels in Patients with Ischemic Stroke by Statin Treatment: Hs-CRP Sub-Study in J-STARS
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Reduction in High-Sensitivity C-Reactive Protein Levels in Patients with Ischemic Stroke by Statin Treatment: Hs-CRP Sub-Study in J-STARS

机译：他汀类药物治疗可降低缺血性卒中患者的高敏C反应蛋白水平：J-STARS中的Hs-CRP子研究

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Aims : The pleiotropic effects of statins on recurrent stroke remain unclear. We investigated the effects of pravastatin on high-sensitivity C-reactive proteins (Hs-CRP) in ischemic stroke, and explored the impact of Hs-CRP on recurrent stroke and vascular events. Methods : This randomized open-label trial was ancillary to the J-STARS trial. One thousand and ninety-five patients with non-cardiogenic ischemic stroke were assigned to the pravastatin ( n =545) or control groups ( n =550). The primary and secondary endpoints were serum Hs-CRP reduction and stroke recurrence, including both ischemic and hemorrhagic ones, respectively. Onset of vascular events and each stroke subtype in relation to Hs-CRP levels were also determined. Results : In the pravastatin treatment group, Hs-CRP levels (median 711 μg/L, IQR 344–1500) significantly decreased 2 months later (median 592 μg/L, IQR 301–1390), and they remained significantly lower until the end of the study. However, in the control group, baseline Hs-CRP levels were similar to those 2 months later. The reduction of Hs-CRP levels from the baseline to 2 months in the pravastatin group was statistically significant compared with the control ( p =0.007). One SD increase in log-transformed Hs-CRP increased the risk of stroke recurrence (HR 1.17, 95% CI 0.97–1.40) and vascular events (HR 1.30, 95% CI 1.12–1.51). With an Hs-CRP cut-off of 1000 μg/L, higher Hs-CRP significantly increased the risk of recurrent stroke (HR 1.50, 95% CI 1.03–2.17)and vascular events (HR 1.68, 95% CI 1.23–2.29). Conclusion : In non-cardiogenic ischemic stroke, pravastatin treatment may reduce vascular inflammation as assessed by Hs-CRP, and higher Hs-CRP levels appeared to increase the risk of recurrent stroke and vascular events.
机译：目的：他汀类药物对复发性中风的多效性作用尚不清楚。我们调查了普伐他汀对缺血性卒中中高敏C反应蛋白（Hs-CRP）的影响，并探讨了Hs-CRP对复发性中风和血管事件的影响。方法：该随机开放标签试验是J-STARS试验的辅助试验。 195名非心源性缺血性卒中患者被分为普伐他汀（n = 545）或对照组（n = 550）。主要和次要终点是血清Hs-CRP降低和中风复发，分别包括缺血性和出血性。还确定了血管事件的发作以及与Hs-CRP水平相关的每种中风亚型。结果：在普伐他汀治疗组中，Hs-CRP水平（中值711μg/ L，IQR 344–1500）在2个月后显着降低（中值592μg/ L，IQR 301–1390），并且直到结束时仍显着降低研究。但是，对照组的基线Hs-CRP水平与2个月后的水平相似。与对照组相比，普伐他汀组从基线到2个月的Hs-CRP水平降低具有统计学意义（p = 0.007）。对数转化的Hs-CRP增加1 SD会增加中风复发（HR 1.17，95％CI 0.97-1.40）和血管事件（HR 1.30，95％CI 1.12-1.51）的风险。 Hs-CRP临界值为1000μg/ L，较高的Hs-CRP会显着增加复发性中风（HR 1.50，95％CI 1.03–2.17）和血管事件（HR 1.68，95％CI 1.23–2.29）的风险。结论：在非心源性缺血性中风中，普伐他汀治疗可以减轻血管炎症，如通过Hs-CRP评估，较高的Hs-CRP水平似乎会增加复发性中风和血管事件的风险。

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