Plasma β-Thromboglobulin Is Inversely Associated With Cerebral Microbleeds in Atrial Fibrillation.

IF 8.9 1区医学 Q1 CLINICAL NEUROLOGY

Stroke Pub Date : 2025-09-17 DOI:10.1161/STROKEAHA.124.049972

Benedict C Kupper, Martin F Reiner, Laura Werlen, Stefanie Aeschbacher, Pratintip Lee, Meret Allemann, Giorgio Moschovitis, Thomas Lüscher, Giovanni G Camici, Nicolas Rodondi, Luise Adam, Pascal B Meyre, Leo H Bonati, Tim Sinnecker, Michael Kühne, Stefan Osswald, David Conen, Jürg H Beer

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引用次数: 0

Abstract

Background: Biomarkers may increase the understanding of the pathophysiology of brain lesions in newly evaluated atrial fibrillation. BTG (β-thromboglobulin) is released from platelet alpha granules upon activation, reflecting platelet activation and destruction. We assessed the association of plasma BTG with cerebral microbleeds (CMBs) and ischemic brain lesions using brain magnetic resonance imaging (bMRI) in patients with atrial fibrillation.

Methods: BTG was analyzed using the Luminex assay. CMBs and ischemic brain lesions were detected by standardized bMRI of 1724 patients from the Swiss-Atrial Fibrillation cohort, a prospective, national, multicenter cohort study that enrolled patients between 2014 and 2017. For this cross-sectional analysis, associations of BTG with bMRI lesions were evaluated by logistic and linear regression analyses using 2 models. The first model was adjusted for age and sex, and the second model was additionally multivariable-adjusted for a large number of clinical characteristics, including coronary artery disease, hypertension, diabetes, chronic kidney disease, history of heart failure, major bleeding, as well as concomitant platelet inhibitor, and anticoagulation therapy.

Results: Mean age at baseline was 72.5 years (SD, 8.4), and 27.3% were female. On bMRI, CMBs were found in 369 patients (21.4%) and cerebral infarcts in 635 (36.8%). After multivariable adjustment, a 1-unit increase of log-transformed plasma BTG was associated with 25% lower odds of having CMBs (odds ratio, 0.75 [95% CI, 0.59-0.96]). However, BTG was not associated with the presence of large noncortical or cortical infarcts (odds ratio, 0.85 [95% CI, 0.66-1.09]) or small noncortical infarcts (odds ratio, 1.06 [95% CI, 0.83-1.35]).

Conclusions: In patients with atrial fibrillation, the platelet-specific biomarker BTG was inversely and independently associated with CMBs on bMRI. Low-grade platelet activation may improve vascular integrity.

Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02105844.

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心房颤动患者血浆β-血栓球蛋白与脑微出血呈负相关

背景：生物标志物可能增加对新评估心房颤动的脑病变病理生理学的理解。BTG （β-血小板球蛋白）在活化时从血小板α颗粒释放，反映血小板的活化和破坏。我们利用脑磁共振成像（bMRI）评估了房颤患者血浆BTG与脑微出血（CMBs）和缺血性脑病变的关系。方法：采用Luminex法分析BTG。通过标准化bMRI检测来自瑞士-心房颤动队列的1724例患者的CMBs和缺血性脑病变，这是一项前瞻性，全国性，多中心队列研究，于2014年至2017年招募患者。在这个横断面分析中，BTG与bMRI病变的关联通过logistic和线性回归分析，使用2个模型进行评估。第一个模型根据年龄和性别进行了调整，第二个模型根据大量临床特征进行了多变量调整，包括冠状动脉疾病、高血压、糖尿病、慢性肾脏疾病、心力衰竭史、大出血以及合并血小板抑制剂和抗凝治疗。结果：基线时平均年龄为72.5岁（SD, 8.4）， 27.3%为女性。脑mri检查发现CMBs 369例（21.4%），脑梗死635例（36.8%）。多变量调整后，log-转化血浆BTG每增加1个单位，发生CMBs的几率降低25%（优势比为0.75 [95% CI, 0.59-0.96]）。然而，BTG与大面积非皮质或皮质梗死（优势比，0.85 [95% CI, 0.66-1.09]）或小面积非皮质梗死（优势比，1.06 [95% CI, 0.83-1.35]）无关。结论：在房颤患者中，血小板特异性生物标志物BTG与bMRI上的CMBs呈负相关且独立相关。低级别血小板活化可改善血管完整性。注册：网址：https://www.clinicaltrials.gov；唯一标识符：NCT02105844。

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来源期刊

Stroke 医学-临床神经学

CiteScore

13.40

自引率

6.00%

发文量

2021

审稿时长

3 months

期刊介绍： Stroke is a monthly publication that collates reports of clinical and basic investigation of any aspect of the cerebral circulation and its diseases. The publication covers a wide range of disciplines including anesthesiology, critical care medicine, epidemiology, internal medicine, neurology, neuro-ophthalmology, neuropathology, neuropsychology, neurosurgery, nuclear medicine, nursing, radiology, rehabilitation, speech pathology, vascular physiology, and vascular surgery. The audience of Stroke includes neurologists, basic scientists, cardiologists, vascular surgeons, internists, interventionalists, neurosurgeons, nurses, and physiatrists. Stroke is indexed in Biological Abstracts, BIOSIS, CAB Abstracts, Chemical Abstracts, CINAHL, Current Contents, Embase, MEDLINE, and Science Citation Index Expanded.