三甲胺n -氧化物(TMAO)用于急性缺血性卒中后的风险分层:来自BIOSIGNAL队列研究的结果

IF 4.5 3区 医学 Q1 CLINICAL NEUROLOGY
Johannes Frenger, Benjamin Jeker, Markus Arnold, Gerrit M Grosse, Thomas Pokorny, Laura P Westphal, Corinne Inauen, Giulio Bicciato, Marcel Arnold, Urs Fischer, Gian Marco De Marchis, Georg Kägi, Timo Kahles, Carlo W Cereda, Alejandro Bustamante, Joan Montaner, George Ntaios, Christian Foerch, Katharina Spanaus, Arnold von Eckardstein, Daniel Mueller, Mira Katan
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引用次数: 0

摘要

简介:最近对主要来自亚洲人群的脑卒中患者的研究强调了三甲胺n -氧化物(TMAO)作为预测脑卒中和主要不良心血管事件(MACE)的有价值的血液生物标志物的重要性。然而,其在其他人群缺血性脑卒中后的预后作用尚未全面研究。患者和方法:我们测量了来自多中心BIOSIGNAL队列的1726例急性缺血性卒中患者(症状出现后24小时内)的血浆TMAO水平。使用cox和logistic回归模型调整人口统计学和血管危险因素,我们调查了TMAO与卒中复发、卒中后365天内MACE和90天功能结局的关系。结果:TMAO水平与卒中复发风险无关(n = 108, unadj)。单位HR增加log (TMAO) 1.15, 95% CI 0.88-1.51,调整后。HR 1.07, 95% CI 0.78-1.47)或MACE (n = 309,无统计学意义)。HR = log (TMAO) 1.10,95% CI 0.91-1.3,调整。Hr 0.90, 95% ci 0.74-1.09)。高TMAO血浆水平与不良功能结局之间存在单变量正相关,这种关联在多变量分析中仍然具有统计学意义(unadj)。OR of log (TMAO) 1.56, 95% CI 1.34-1.81,调整。或1.28,95% ci 1.04-1.57)。结论:在这个以白人为主的急性脑卒中患者大队列中,TMAO与复发性脑卒中、MACE或死亡均无独立关联。在单变量和多变量分析中,TMAO与不良功能结局之间存在显著关联,由于其效应量低,可能不具有临床意义。因此,TMAO似乎不是脑卒中后风险分层的临床相关生物标志物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Trimethylamine N-oxide (TMAO) for risk stratification after acute ischemic stroke: Results from the BIOSIGNAL cohort study.

Introduction: Recent studies in stroke patients from predominantly Asian populations have underscored the significance of trimethylamine N-oxide (TMAO) as a valuable blood biomarker for predicting incident strokes and major adverse cardiovascular events (MACE). However, its prognostic role after ischemic stroke in other populations is not yet comprehensively investigated.

Patients and methods: We measured plasma TMAO levels in 1726 acute ischemic stroke patients (within 24 h from symptom onset) from the multicenter BIOSIGNAL cohort. Using cox and logistic regression models adjusting for demographic and vascular risk factors, we investigated the association of TMAO with recurrent stroke, MACE within 365 days and functional outcome at 90 days after stroke.

Results: TMAO levels were not associated with any risk of recurrent stroke (n = 108, unadj. HR per unit increase of log (TMAO) 1.15, 95% CI 0.88-1.51, adjust. HR 1.07, 95% CI 0.78-1.47) or MACE (n = 309, unadj. HR of log (TMAO) 1.10,95% CI 0.91-1.3, adjust. HR 0.90, 95% CI 0.74-1.09). There was an univariable positive association between higher TMAO plasma levels and unfavorable functional outcome, this association remained statistically significant in the multivariable analysis (unadj. OR of log (TMAO) 1.56, 95% CI 1.34-1.81, adjust. OR 1.28, 95% CI 1.04-1.57).

Conclusion: In this large cohort of acute stroke patients from a predominantly White population, TMAO had no independent association with either recurrent stroke, or MACE or death. In univariable, and multivariable analysis, there was a significant association between TMAO and unfavorable functional outcome, which might not be clinically significant due to its low effect size. Therefore, TMAO seems not to be a clinically relevant biomarker for risk stratification after stroke.

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来源期刊
CiteScore
7.50
自引率
6.60%
发文量
102
期刊介绍: Launched in 2016 the European Stroke Journal (ESJ) is the official journal of the European Stroke Organisation (ESO), a professional non-profit organization with over 1,400 individual members, and affiliations to numerous related national and international societies. ESJ covers clinical stroke research from all fields, including clinical trials, epidemiology, primary and secondary prevention, diagnosis, acute and post-acute management, guidelines, translation of experimental findings into clinical practice, rehabilitation, organisation of stroke care, and societal impact. It is open to authors from all relevant medical and health professions. Article types include review articles, original research, protocols, guidelines, editorials and letters to the Editor. Through ESJ, authors and researchers have gained a new platform for the rapid and professional publication of peer reviewed scientific material of the highest standards; publication in ESJ is highly competitive. The journal and its editorial team has developed excellent cooperation with sister organisations such as the World Stroke Organisation and the International Journal of Stroke, and the American Heart Organization/American Stroke Association and the journal Stroke. ESJ is fully peer-reviewed and is a member of the Committee on Publication Ethics (COPE). Issues are published 4 times a year (March, June, September and December) and articles are published OnlineFirst prior to issue publication.
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