Does inflammation predispose to recurrent vascular events after recent transient ischaemic attack and minor stroke? The North West of England transient ischaemic attack and minor stroke (NORTHSTAR) study

被引:20
|
作者
Selvarajah, Johann R. [1 ]
Smith, Craig J. [2 ]
Hulme, Sharon [3 ]
Georgiou, Rachel [2 ]
Sherrington, Charles [2 ]
Staniland, John [2 ]
Illingworth, Karen J. [2 ]
Jury, Francine [4 ]
Payton, Antony [4 ]
Ollier, William E. [4 ]
Vail, Andy [5 ]
Rothwell, Nancy J. [6 ]
Hopkins, Stephen J. [2 ]
Tyrrell, Philippa J. [2 ,3 ]
机构
[1] Western Gen Hosp, Dept Clin Neurosci, Edinburgh EH4 2XU, Midlothian, Scotland
[2] Salford Royal Hosp NHS Fdn Trust, Salford, Lancs, England
[3] Univ Manchester, Sch Biomed, Manchester M13 9PL, Lancs, England
[4] Univ Manchester, Ctr Integrated Genom Med Res, Manchester M13 9PL, Lancs, England
[5] Univ Manchester, Hlth Methodol Res Grp, Manchester M13 9PL, Lancs, England
[6] Univ Manchester, Fac Life Sci, Manchester M13 9PL, Lancs, England
关键词
inflammation; stroke; transient ischaemic attack; vascular events; C-REACTIVE PROTEIN; CORONARY-HEART-DISEASE; ERYTHROCYTE SEDIMENTATION-RATE; P-SELECTIN; RISK; ATHEROSCLEROSIS; INFECTION; PREDICTS; POLYMORPHISMS; INTERLEUKIN-6;
D O I
10.1111/j.1747-4949.2010.00561.x
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and hypothesis Inflammation is implicated in the pathogenesis and outcome of ischaemic injury. Poststroke inflammation is associated with outcome but it remains unclear whether such inflammation precedes or results from ischaemic injury. We hypothesised that inflammatory markers are associated with an increased risk of recurrent vascular events soon after transient ischaemic attack and minor stroke. Methods This was a multicentre, prospective, nested case-control study. Plasma concentrations of C-reactive protein, interleukin-6, interleukin-1-receptor antagonist and fibrinogen, leucocyte counts, erythrocyte sedimentation rate and inflammatory gene allele frequencies were analysed in 711 patients with recent transient ischaemic attack or minor stroke. Cases were defined by the incidence of one or more recurrent vascular events during the three-month follow-up. Association of inflammatory markers with case-status was determined using conditional logistic regression. Results Plasma concentrations of C-reactive protein, interleukin-1-receptor antagonist and interleukin-6 were not associated with case-status. In secondary analyses, only erythrocyte sedimentation rate was significantly associated with case-status (odds ratio 1 center dot 39, 95% confidence interval 1 center dot 03-1 center dot 85; P=0 center dot 03), but this effect did not persist after adjustment for smoking and past history of transient ischaemic attack or stroke. Single nucleotide polymorphisms in four inflammatory genes (interleukin-6, fibrinogen, P-selectin and vascular cell adhesion molecule-1) were nominally associated with case-status. Conclusions Circulating inflammatory markers were not associated with recurrent vascular events. Nominally significant associations between genetic markers and case-status will require replication. These data provide little evidence for an inflammatory state predisposing to stroke and other vascular events in a susceptible population.
引用
收藏
页码:187 / 194
页数:8
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