Endothelial and Leukocyte-Derived Microvesicles and Cardiovascular Risk After Stroke
| Autor: | Jessica L. Rohmann, Peter U. Heuschmann, Matthias Endres, Alexander H. Nave, Sophie K. Piper, Ulf Landmesser, Shufan Huo, Pia S. Sperber, Nicolle Kränkel, Bob Siegerink, Thomas G. Liman |
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| Rok vydání: | 2020 |
| Předmět: |
Male
blood [Ischemic Stroke] Myocardial Infarction mortality [Cardiovascular Diseases] diagnosis [Ischemic Stroke] Severity of Illness Index 0302 clinical medicine Cell-Derived Microparticles Recurrence Interquartile range Leukocytes Prospective Studies 030212 general & internal medicine Myocardial infarction Prospective cohort study epidemiology [Ischemic Stroke] Stroke blood [Biomarkers] Hazard ratio Middle Aged Prognosis epidemiology [Myocardial Infarction] epidemiology [Cardiovascular Diseases] Quartile Cardiovascular Diseases Cardiology Female Risk medicine.medical_specialty diagnosis [Cardiovascular Diseases] 03 medical and health sciences blood [Cardiovascular Diseases] Internal medicine mortality [Ischemic Stroke] medicine Humans ddc:610 Ischemic Stroke Aged business.industry Proportional hazards model Endothelial Cells medicine.disease Confidence interval Neurology (clinical) business Biomarkers 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Neurology 96(6), 10.1212/WNL.0000000000011223-(2021). doi:10.1212/WNL.0000000000011223 |
| ISSN: | 1526-632X 0028-3878 |
| DOI: | 10.1212/wnl.0000000000011223 |
| Popis: | ObjectiveTo determine the role of circulating microvesicles (MV) on long-term cardiovascular outcomes after stroke, we measured them in patients with first-ever stroke with a 3-year follow-up.MethodsIn the Prospective Cohort With Incident Stroke Berlin (PROSCIS-B), patients with first-ever ischemic stroke were followed up for 3 years. The primary combined endpoint consisted of recurrent stroke, myocardial infarction, and all-cause mortality. Citrate-blood levels of endothelial MV (EMV), leukocyte-derived MV (LMV), monocytic MV (MMV), and platelet-derived MV (PMV) were measured with flow cytometry. Kaplan-Meier curves and adjusted Cox proportional hazards models were used to estimate the effect of MV levels on the combined endpoint.ResultsFive hundred seventy-one patients were recruited (median age 69 years, 39% female, median NIH Stroke Scale score 2, interquartile range 1–4), and 95 endpoints occurred. Patients with levels of EMV (adjusted hazard ratio [HR] 2.5, 95% confidence interval [CI] 1.2–4.9) or LMV (HR 3.1, 95% CI 1.4–6.8) in the highest quartile were more likely to experience an event than participants with lower levels with the lowest quartile used as the reference category. The association was less pronounced for PMV (HR 1.7, 95% CI 0.9–3.2) and absent for MMV (HR 1.1, 95% CI 0.6–1.8).ConclusionHigh levels of EMV and LMV after stroke were associated with worse cardiovascular outcome within 3 years. These results reinforce that endothelial dysfunction and vascular inflammation affect the long-term prognosis after stroke. EMV and LMV might play a role in risk prediction for stroke patients.ClinicalTrials.gov IdentifierNCT01363856.Classification of EvidenceThis study provides Class II evidence of the effect of MV levels on subsequent stroke, myocardial infarction, or all-cause mortality in survivors of mild stroke. |
| Databáze: | OpenAIRE |
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