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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Inflammation and Hemostasis Biomarkers for Predicting Stroke in Postmenopausal Women: The Women's Health Initiative Observational Study
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Inflammation and Hemostasis Biomarkers for Predicting Stroke in Postmenopausal Women: The Women's Health Initiative Observational Study

机译：炎症和止血生物标志物预测绝经后妇女的中风：妇女健康倡议的观察性研究

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Background: Inflammatory and hemostasis-related biomarkers may identify women at risk of stroke. Methods: Hormones and Biomarkers Predicting Stroke is a study of ischemic stroke among postmenopausal women participating in the Women's Health Initiative observational study (n = 972 case-control pairs). A Biomarker Risk Score (BRS) was derived from levels of 7 inflammatory and hemostasis-related biomarkers that appeared individually to predict risk of ischemic stroke: C-reactive protein (CRP), interleukin-6, tissue plasminogen activator, D-dimer, white blood cell count, neopterin, and homocysteine. The c index was used to evaluate discrimination. Results: Of all the individual biomarkers examined, CRP emerged as the only independent single predictor of ischemic stroke (adjusted odds ratio comparing Quartile_4 v Quartile_1 = 1.64,95% confidence interval: 1.15-2.32, P = .01) after adjustment for other biomarkers and standard stroke risk factors. The BRS identified a gradient of increasing stroke risk with agreater number of elevated inflamma-tory/hemostasis biomarkers, and improved the c index significantly compared with standard stroke risk factors (P = .02). Among the subset of individuals who met current criteria for high-risk levels of CRP (>3.0 mg/L), the BRS defined an approximately 2-fold gradient of risk. We found no evidence for a relationship between stroke and levels of E-selectin, fibrinogen, tumor necrosis factor-a, vascular cell adhesion molecule-1, prothrombin fragment 1+2, Factor VIIC, or plasminogen activator inhibitor-1 antigen (P > .15). Discussion: The findings support the further exploration of multiple biomarker panels to develop approaches for stratifying an individual's risk of stroke.
机译：背景：与炎症和止血相关的生物标记物可能会识别出有中风风险的女性。方法：激素和生物标志物预测卒中是一项参与“妇女健康倡议”观察性研究（n = 972个病例对照对）的绝经后妇女中缺血性卒中的研究。生物标志物风险评分（BRS）来自7种与炎症和止血相关的生物标志物的水平，其分别出现以预测缺血性中风的危险：C反应蛋白（CRP），白介素-6，组织纤溶酶原激活物，D-二聚体，白色血细胞计数，新蝶呤和高半胱氨酸。 c指数用于评估歧视。结果：在所有其他生物标志物中，CRP成为唯一的缺血性卒中的独立预测指标（校正后的比值比，比对Quartile_4 v Quartile_1 = 1.64,95％置信区间：1.15-2.32，P = .01）和标准的中风危险因素。 BRS识别出卒中风险增加与炎性/止血生物标志物升高的数目的增加之间的梯度，并且与标准卒中危险因素相比，c指数显着改善（P = .02）。在满足当前高风险CRP水平标准（> 3.0 mg / L）的个体子集中，BRS定义了大约2倍的风险梯度。我们没有发现卒中与E-选择蛋白，纤维蛋白原，肿瘤坏死因子-a，血管细胞粘附分子-1，凝血酶原片段1 + 2，因子VIIC或纤溶酶原激活物抑制剂1抗原水平之间存在关联的证据（P> .15）。讨论：研究结果支持对多个生物标志物面板的进一步探索，以开发出对个体中风风险进行分层的方法。

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