多种炎症因子介导的急性缺血性卒中后颈动脉粥样硬化斑块与90天预后的关系：一项队列和孟德尔随机研究

IF 3.2 2区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

International journal of cardiology Pub Date : 2025-07-12 DOI:10.1016/j.ijcard.2025.133609

Tonglong Jin , Yuan Zhu , Hui Huang , Peian Liu , Yongxing Deng , Peiyi Mo , Ziyan Cai , Hui Jiang , Zhaoyao Chen , Wenlei Li , Zhuyuan Fang , Minghua Wu

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引用次数: 0

摘要

本研究探讨了颈动脉斑块最大厚度（cPTmax）、颈动脉内膜-中膜厚度（cIMT）与急性缺血性卒中（AIS）患者90天预后的关系，以及炎症因子的介导作用。方法我们招募了951例AIS患者，他们在2019年6月至2023年11月期间接受了颈动脉超声检查。计算cPTmax、单核细胞（Mono）及淋巴细胞-单核细胞比值（LMR）和单核细胞-高密度脂蛋白比值（MHR）值。采用受试者工作特征（ROC）曲线分析，确定Mono、LMR和MHR作为中介变量的敏感性和特异性，并评价其对不良预后的预测价值。然后，我们进行了双样本孟德尔随机化，以估计cIMT对IS的独立影响，并探讨了oncostatin M （OSM）的中介作用。结果scptmax与不良预后呈正相关(p <；0.001)。中介分析显示，包括Mono、LMR和MHR在内的多种炎症因子发挥了积极的中介作用。在双样本孟德尔随机化中，我们发现cIMT与缺血性脑卒中呈正相关（β = 3.115, 95% CI: 1.519-4.710），而OSM具有负向中介作用，中介效应值为7.5%。结论我们的队列研究显示，cPTmax与急性脑卒中后90天的不良预后呈正相关，Mono、LMR和MHR参与了这一过程。一项孟德尔随机化（MR）研究显示，cIMT增加与IS风险增加之间存在因果关系。OSM在这一过程中的中介作用可以降低IS的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Relationship between carotid atherosclerotic plaques and 90-day prognosis after acute ischemic stroke mediated by multiple inflammatory factors: A cohort and Mendelian randomization study

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Relationship between carotid atherosclerotic plaques and 90-day prognosis after acute ischemic stroke mediated by multiple inflammatory factors: A cohort and Mendelian randomization study

Background

We explored the relationship between maximum carotid plaque thickness (cPTmax), carotid intima-media thickness (cIMT), and the 90-day prognosis of patients with acute ischemic stroke (AIS), as well as the mediating roles of inflammatory factors.

Methods

We enrolled 951 patients with AIS who underwent carotid artery ultrasonography between June 2019 and November 2023. cPTmax, monocytes (Mono) and the calculated lymphocyte-monocyte ratio (LMR) and monocyte-to-high-density lipoprotein ratio (MHR) values were obtained. Receiver operating characteristic (ROC) curve analysis was used to determine the sensitivity and specificity of Mono, LMR, and MHR as mediating variables, and their predictive value for poor prognosis was evaluated. We then performed two-sample Mendelian randomization to estimate the independent effect of cIMT on IS and explored the mediation effect of oncostatin M (OSM).

Results

cPTmax was positively correlated with the poor outcomes (p < 0.001). Mediation analysis revealed that multiple inflammatory factors, including Mono, LMR, and MHR, acted as positive mediators. In the two-sample Mendelian randomization, we found that cIMT was positively associated with ischemic stroke (β = 3.115, 95 % CI: 1.519–4.710), whereas OSM played a negative mediating role, with a mediating effect value of 7.5 %.

Conclusions

Our cohort study showed a positive correlation between cPTmax and poor prognosis 90 days after acute stroke, with Mono, LMR, and MHR mediating this process. A Mendelian randomization (MR) study showed a causal relationship between an increase in cIMT and an increased risk of IS. The mediating role of OSM in this process can reduce the risk of IS.

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来源期刊

International journal of cardiology 医学-心血管系统

CiteScore

6.80

自引率

5.70%

发文量

758

审稿时长

44 days

期刊介绍： The International Journal of Cardiology is devoted to cardiology in the broadest sense. Both basic research and clinical papers can be submitted. The journal serves the interest of both practicing clinicians and researchers. In addition to original papers, we are launching a range of new manuscript types, including Consensus and Position Papers, Systematic Reviews, Meta-analyses, and Short communications. Case reports are no longer acceptable. Controversial techniques, issues on health policy and social medicine are discussed and serve as useful tools for encouraging debate.