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Liuzzo G, Pedicino D. Weekly Journal Scan: colchicine after an acute ischaemic stroke shows no CHANCE of preventing recurrent events. Eur Heart J 2024:ehae498. [PMID: 39101474 DOI: 10.1093/eurheartj/ehae498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/06/2024] Open
Affiliation(s)
- Giovanna Liuzzo
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
- Department of Cardiovascular and Pulmonary Sciences, Catholic University School of Medicine, Largo F. Vito 1, 00168 Rome, Italy
| | - Daniela Pedicino
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
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2
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Ma J, Xie H, Yuan C, Shen J, Chen J, Chen Q, Liu J, Tong Q, Sun J. The gut microbial signatures of patients with lacunar cerebral infarction. Nutr Neurosci 2024; 27:620-636. [PMID: 37538045 DOI: 10.1080/1028415x.2023.2242121] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
BACKGROUND Emerging evidence revealed that gut microbial dysbiosis is involved in the pathogenesis of multiple neurological diseases, but there is little available data on the relationship between gut microbiota and lacunar cerebral infarction (LCI). METHODS Fecal samples from acute LCI patients (n = 65) and matched healthy controls (n = 65) were collected. The compositions and potential functions of the gut microbiota were estimated. RESULTS The results showed that there were significant gut microbial differences between LCI and control groups. Patients with LCI had higher abundances of genus Lactobacillus, Streptococcus, Veillonella, Acidaminococcus, Bacillus, Peptoclostridium, Intestinibacter, Alloscardovia and Cloacibacillus but lower proportions of genus Agathobacter and Lachnospiraceae_UCG-004. Investigating further these microbes such as Lactobacillus and Veillonella were correlated with clinical signs. Moreover, we found that 9 gene functions of gut microbiota were different between LCI patients and controls, which were associated with amino acid metabolism and inflammatory signal transduction. Notably, four optimal microbial markers were determined, and the combination of Streptococcus, Lactobacillus, Agathobacter, Lachnospiraceae_UCG-004 and the three risk factors achieved an area under the curve (AUC) value of 0.854 to distinguish LCI from controls. CONCLUSION These findings revealed the characterizing of gut microbiota in LCI patients and provided potential microbial biomarkers for clinical diagnosis of LCI.
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Affiliation(s)
- Jiaying Ma
- Department of Geriatrics, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Huijia Xie
- Department of Geriatrics, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Chengxiang Yuan
- Department of Neurology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Jie Shen
- Department of Neurology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Jiaxin Chen
- Department of Geriatrics, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Qionglei Chen
- Department of Geriatrics, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Jiaming Liu
- Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Qiuling Tong
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Jing Sun
- Department of Geriatrics, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
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Lim A, Ma H, Johnston SC, Singhal S, Muthusamy S, Wang Y, Pan Y, Coutts SB, Hill MD, Ois A, Kapral MK, Knoflach M, Woodhouse LJ, Bath PM, Phan TG. Ninety-Day Stroke Recurrence in Minor Stroke: Systematic Review and Meta-Analysis of Trials and Observational Studies. J Am Heart Assoc 2024; 13:e032471. [PMID: 38641856 PMCID: PMC11179866 DOI: 10.1161/jaha.123.032471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 03/18/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND Risk of recurrence after minor ischemic stroke is usually reported with transient ischemic attack. No previous meta-analysis has focused on minor ischemic stroke alone. The objective was to evaluate the pooled proportion of 90-day stroke recurrence for minor ischemic stroke, defined as a National Institutes of Health Stroke Scale severity score of ≤5. METHODS AND RESULTS Published papers found on PubMed from 2000 to January 12, 2021, reference lists of relevant articles, and experts in the field were involved in identifying relevant studies. Randomized controlled trials and observational studies describing minor stroke cohort with reported 90-day stroke recurrence were selected by 2 independent reviewers. Altogether 14 of 432 (3.2%) studies met inclusion criteria. Multilevel random-effects meta-analysis was performed. A total of 6 randomized controlled trials and 8 observational studies totaling 45 462 patients were included. The pooled 90-day stroke recurrence was 8.6% (95% CI, 6.5-10.7), reducing by 0.60% (95% CI, 0.09-1.1; P=0.02) with each subsequent year of publication. Recurrence was lowest in dual antiplatelet trial arms (6.3%, 95% CI, 4.5-8.0) when compared with non-dual antiplatelet trial arms (7.2%, 95% CI, 4.7-9.6) and observational studies 10.6% (95% CI, 7.0-14.2). Age, hypertension, diabetes, ischemic heart disease, or known atrial fibrillation had no significant association with outcome. Defining minor stroke with a lower National Institutes of Health Stroke Scale threshold made no difference - score ≤3: 8.6% (95% CI, 6.0-11.1), score ≤4: 8.4% (95% CI, 6.1-10.6), as did excluding studies with n<500%-7.3% (95% CI, 5.5-9.0). CONCLUSIONS The risk of recurrence after minor ischemic stroke is declining over time but remains important.
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Affiliation(s)
- Andy Lim
- School of Clinical Sciences at Monash HealthMonash UniversityMelbourneVictoriaAustralia
- Department of Emergency MedicineMonash HealthMelbourneVictoriaAustralia
| | - Henry Ma
- School of Clinical Sciences at Monash HealthMonash UniversityMelbourneVictoriaAustralia
- Department of NeurologyMonash HealthMelbourneVictoriaAustralia
| | | | - Shaloo Singhal
- School of Clinical Sciences at Monash HealthMonash UniversityMelbourneVictoriaAustralia
- Department of NeurologyMonash HealthMelbourneVictoriaAustralia
| | - Subramanian Muthusamy
- School of Clinical Sciences at Monash HealthMonash UniversityMelbourneVictoriaAustralia
- Department of NeurologyMonash HealthMelbourneVictoriaAustralia
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- China National Clinical Research Centre for Neurological DiseasesBeijingChina
| | - Yuesong Pan
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- China National Clinical Research Centre for Neurological DiseasesBeijingChina
| | - Shelagh B. Coutts
- Department of Clinical Neurosciences, Radiology and Community Health SciencesHotchkiss Brain Institute, University of CalgaryAlbertaCanada
| | - Michael D. Hill
- Department of Clinical Neurosciences, Radiology and Community Health SciencesHotchkiss Brain Institute, University of CalgaryAlbertaCanada
| | - Angel Ois
- Servicio de Neurologı’a, Hospital del MarBarcelonaSpain
| | | | - Michael Knoflach
- Department of NeurologyInnsbruck Medical UniversityInnsbruckAustria
| | - Lisa J. Woodhouse
- Stroke Trials Unit, Mental Health & Clinical NeuroscienceUniversity of Nottingham, Queen’s Medical CentreNottinghamUnited Kingdom
| | - Philip M. Bath
- Stroke Trials Unit, Mental Health & Clinical NeuroscienceUniversity of Nottingham, Queen’s Medical CentreNottinghamUnited Kingdom
| | - Thanh G. Phan
- School of Clinical Sciences at Monash HealthMonash UniversityMelbourneVictoriaAustralia
- Department of NeurologyMonash HealthMelbourneVictoriaAustralia
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4
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Pulukool SK, Srimadh Bhagavatham SK, Vijay SK, Almansour AI, Chaudhary S, Abuyousef F, Saleh N, Tripathi P. Noninvasive cardiac-specific biomarkers for the diagnosis and prevention of vascular stenosis in cardiovascular disorder. Front Pharmacol 2024; 15:1376226. [PMID: 38725669 PMCID: PMC11079267 DOI: 10.3389/fphar.2024.1376226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 04/02/2024] [Indexed: 05/12/2024] Open
Abstract
Background The most frequent lesion in the blood vessels feeding the myocardium is vascular stenosis, a condition that develops slowly but can prove to be deadly in a long run. Non-invasive biomarkers could play a significant role in timely diagnosis, detection and management for vascular stenosis events associated with cardiovascular disorders. Aims The study aimed to investigate high sensitivity troponin I (hs-TnI), cardiac troponin I (c-TnI) and high sensitivity C-reactive protein (hs-CRP) that may be used solely or in combination in detecting the extent of vascular stenosis in CVD patients. Methodology 274 patients with dyspnea/orthopnea complaints visiting the cardiologists were enrolled in this study. Angiographic study was conducted on the enrolled patients to examine the extent of stenosis in the five prominent vessels (LDA, LCX, PDA/PLV, RCA, and OM) connected to the myocardium. Samples from all the cases suspected to be having coronary artery stenosis were collected, and subjected to biochemical evaluation of certain cardiac inflammatory biomarkers (c-TnI, hsTn-I and hs-CRP) to check their sensitivity with the level of vascular stenosis. The extent of mild and culprit stenosis was detected during angiographic examination and the same was reported in the form significant (≥50% stenosis in the vessels) and non-significant (<50% stenosis in the vessels) Carotid Stenosis. Ethical Clearance for the study was provided by Dr. Ram Manohar Lohia Institute of Medical Sciences Institutional Ethical Committee. Informed consent was obtained from all the participants enrolled in the study. Results We observed that 85% of the total population enrolled in this study was suffering from hypertension followed by 62.40% detected with sporadic episodes of chest pain. Most of the subjects (42% of the total population) had stenosis in their LAD followed by 38% who had stenosis in their RCA. Almost 23% patients were reported to have stenosis in their LCX followed by OM (18% patients), PDA/PLV (13%) and only 10% patients had blockage problem in their diagonal. 24% of the subjects were found to have stenosis in a single vessel and hence were categorized in the Single Vessel Disease (SVD) group while 76% were having stenosis in two or more than two arteries (Multiple Vessel Disease). hs-TnI level was found to be correlated with the levels of stenosis and was higher in the MVD group as compared to the SVD group. Conclusion hs-TnI could be used as a novel marker as it shows prominence in detecting the level of stenosis quite earlier as compared to c-TnI which gets detected only after a long duration in the CVD patients admitted for angiography. hs- CRP gets readily detected as inflammation marker in these patients and hence could be used in combination with hs-TnI to detect the risk of developing coronary artery disease.
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Affiliation(s)
- Sujith Kumar Pulukool
- Department of Biosciences, Sri Sathya Sai Institute of Higher Learning, Puttaparthi, Andhra Pradesh, India
| | | | - Sudarshan K. Vijay
- Department of Cardiology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | | | - Sandeep Chaudhary
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research (NIPER-R), Lucknow, Uttar Pradesh, India
| | - Farah Abuyousef
- Department of Chemistry, College of Science, United Arab Emirates (UAE) University, Al Ain, United Arab Emirates
| | - Na’il Saleh
- Department of Chemistry, College of Science, United Arab Emirates (UAE) University, Al Ain, United Arab Emirates
| | - Pratima Tripathi
- Department of Biochemistry, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Sun X, Pan Y, Luo Y, Guo H, Zhang Z, Wang D, Li C, Sun X. Naoxinqing tablet protects against cerebral ischemic/reperfusion injury by regulating ampkα/NAMPT/SIRT1/PGC-1α pathway. JOURNAL OF ETHNOPHARMACOLOGY 2024; 322:117672. [PMID: 38159826 DOI: 10.1016/j.jep.2023.117672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/01/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024]
Abstract
AIM OF THE STUDY Naoxinqing (NXQ) tablets are derived from persimmon leaves and are widely used in China for promoting blood circulation and removing blood stasis in China. We aimed to explore whether NXQ has the therapeutic effect on ischemic stroke and explored its possible mechanism. MATERIALS AND METHODS The cerebral artery occlusion/reperfusion (MCAO/R) surgery was used to establish the cerebral ischemic/reperfusion rat model. NXQ (60 mg/kg and 120 mg/kg) were administered orally. The TTC staining, whole brain water content, histopathology staining, immunofluorescent staining, enzyme-linked immunosorbent assay (ELISA) and Western blot analyses were performed to determine the therapeutical effect of NXQ on MCAO/R rats. RESULTS The study demonstrated that NXQ reduced the cerebral infarction volumes and neurologic deficits in MCAO/R rats. The neuroprotective effects of NXQ were accompanied by inhibited oxidative stress and inflammation. The nerve regeneration effects of NXQ were related to regulating the AMPKα/NAMPT/SIRT1/PGC-1α pathway. CONCLUSION In summary, our results revealed that NXQ had a significant protective effect on cerebral ischemia-reperfusion injury in rats. This study broadens the therapeutic scope of NXQ tablets and provides new neuroprotective mechanisms of NXQ as an anti-stroke therapeutic agent.
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Affiliation(s)
- Xiao Sun
- Key Laboratory of Bioactive Substances and Resources Utilization of Chinese Herbal Medicine, Ministry of Education, Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Beijing Key Laboratory of Innovative Drug Discovery of Traditional Chinese Medicine (Natural Medicine) and Translational Medicine, Beijing, China
| | - Yunfeng Pan
- Key Laboratory of Bioactive Substances and Resources Utilization of Chinese Herbal Medicine, Ministry of Education, Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Beijing Key Laboratory of Innovative Drug Discovery of Traditional Chinese Medicine (Natural Medicine) and Translational Medicine, Beijing, China
| | - Yun Luo
- Key Laboratory of Bioactive Substances and Resources Utilization of Chinese Herbal Medicine, Ministry of Education, Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Beijing Key Laboratory of Innovative Drug Discovery of Traditional Chinese Medicine (Natural Medicine) and Translational Medicine, Beijing, China
| | - Haibiao Guo
- Hutchison Whampoa Guangzhou Baiyunshan Chinese Medicine Co., Ltd., Guangzhou, China
| | - Zhixiu Zhang
- Key Laboratory of Bioactive Substances and Resources Utilization of Chinese Herbal Medicine, Ministry of Education, Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Beijing Key Laboratory of Innovative Drug Discovery of Traditional Chinese Medicine (Natural Medicine) and Translational Medicine, Beijing, China
| | - Deqin Wang
- Hutchison Whampoa Guangzhou Baiyunshan Chinese Medicine Co., Ltd., Guangzhou, China
| | - Chuyuan Li
- Hutchison Whampoa Guangzhou Baiyunshan Chinese Medicine Co., Ltd., Guangzhou, China.
| | - Xiaobo Sun
- Key Laboratory of Bioactive Substances and Resources Utilization of Chinese Herbal Medicine, Ministry of Education, Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Beijing Key Laboratory of Innovative Drug Discovery of Traditional Chinese Medicine (Natural Medicine) and Translational Medicine, Beijing, China.
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Li J, Pan Y, Wang M, Meng X, Lin J, Li Z, Li H, Wang Y, Zhao X, Liu L, Wang Y. High-Sensitivity C-reactive Protein and Intracranial Arterial Stenosis Predicted Recurrent Stroke and Dependence or Death in Minor Stroke or Transient Ischemic Attack. J Atheroscler Thromb 2024; 31:249-258. [PMID: 37704441 PMCID: PMC10918048 DOI: 10.5551/jat.64229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 07/18/2023] [Indexed: 09/15/2023] Open
Abstract
AIMS Inflammation is associated with vascular events. We aimed to investigate the relationship between high-sensitivity C-reactive protein (hsCRP) levels with and without intracranial arterial stenosis (ICAS) and the prognosis of patients with minor stroke or transient ischemic attack. METHODS We used data from the Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events trial (derivation cohort) and the Third China National Stroke Registry (validation cohort). Patients were divided into four groups according to the dichotomy of hsCRP level and ICAS status. The primary outcome was new ischemic stroke within 90 days, and the secondary outcome was dependence or death (Modified Rankin Scale score of 3-6) at 90 days. The associations between hsCRP level with and without ICAS and risk of outcomes were analyzed using multivariate Cox regression and logistic regression models. RESULTS In the derivation cohort, compared with patients with nonelevated hsCRP levels and no ICAS, those with both elevated hsCRP levels and ICAS had increased risk of recurrent stroke (adjusted hazard ratio [HR], 2.62; 95% confidence interval [CI], 1.28-5.34; p=0.008) and dependence or death (adjusted odds ratio [OR], 7.58; 95% CI, 1.30-44.13; p=0.02). Consistent relationships of elevated hsCRP levels and presence of ICAS with recurrent stroke (adjusted HR, 1.67; 95% CI, 1.13-2.45; p=0.009) and dependence or death (adjusted OR, 1.87; 95% CI, 1.23-2.84; p=0.003) were observed in the validation cohort. CONCLUSION Concomitant presence of increased hsCRP levels and ICAS was associated with increased risk of stroke recurrence and dependence or death in patients with minor ischemic stroke or transient ischemic attack.
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Affiliation(s)
- Jiejie Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University and China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yuesong Pan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University and China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Mengxing Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University and China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Xia Meng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University and China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Jinxi Lin
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University and China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Zixiao Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University and China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Hao Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University and China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yilong Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University and China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University and China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Liping Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University and China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases; Advanced Innovation Center for Human Brain Protection, Capital Medical University and Clinical Center for Precision Medicine in Stroke, Capital Medical University, Beijing, China
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Luo D, Yu B, Sun S, Chen B, Harkare HV, Wang L, Pan J, Huang B, Song Y, Ma T, Shi S. Effects of adjuvant berberine therapy on acute ischemic stroke: A meta-analysis. Phytother Res 2023; 37:3820-3838. [PMID: 37421347 DOI: 10.1002/ptr.7920] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 05/10/2023] [Accepted: 05/27/2023] [Indexed: 07/10/2023]
Abstract
We conducted a meta-analysis to evaluate the clinical efficacy of berberine (BBR) in treating acute ischemic stroke (AIS), explore its anti-inflammatory effects, and assess its potential applications for AIS patients. We comprehensively searched nine databases from inception until July 1, 2022, to identify clinical trials investigating the use of BBR in treating AIS. We performed statistical analyses using RevMan5.4 software and focused on primary outcomes such as inflammatory markers as well as secondary outcomes including immune system indicators, relevant biomarkers, carotid artery atherosclerosis, and adverse reactions. Our analysis included data from 17 clinical trials involving 1670 patients with AIS. Our results revealed that BBR in combination with conventional treatment significantly reduced levels of high-sensitivity C-reactive protein (hs-CRP), macrophage migration inhibitory factor (MIF), interleukin-6 (IL-6), complement C3, hypoxic inducible factor-1 α (HIF-1α), cysteine protease-3 (Caspase-3), the national institutes of health stroke scale (NIHSS), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), carotid intima-media thickness (IMT), the number of unstable plaques, and carotid crouse score on ultrasound when compared with conventional treatment alone. Furthermore, combining BBR with conventional treatment may improve the overall effective rate. Therefore, our findings suggest that BBR can be used as an adjuvant therapy for AIS due to its ability to reduce inflammatory cytokine levels, providing a novel therapeutic option for AIS. However, larger randomized controlled trials are necessary to confirm these results.
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Affiliation(s)
- Dan Luo
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Baili Yu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shoukai Sun
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Bonan Chen
- Department of Anatomical and Cellular Pathology, State Key Laboratory of Translational Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Harsh Vivek Harkare
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Longlong Wang
- Friedrich Miescher Institute for Biomedical Research, Basel, Switzerland
| | - Jie Pan
- Department of Pathology, Stanford University School of Medicine, Palo Alto, California, USA
| | - Bin Huang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yang Song
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Tianhong Ma
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shihua Shi
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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Wang L, Yang L, Liu H, Pu J, Li Y, Tang L, Chen Q, Pu F, Bai D. C-Reactive Protein Levels and Cognitive Decline following Acute Ischemic Stroke: A Systematic Review and Meta-Analysis. Brain Sci 2023; 13:1082. [PMID: 37509012 PMCID: PMC10377587 DOI: 10.3390/brainsci13071082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
Cognitive decline (CD) is devastating with a high incidence in patients after stroke. Although some studies have explored underlying associations between C-reactive protein (CRP) levels and cognitive decline after stroke, consistent results have not been obtained. Therefore, this meta-analysis aimed to explore whether or not higher levels of C-reactive proteins were associated with an increased risk of cognitive decline after stroke. To this end, PubMed, Embase, the Cochrane Library, and Web of Science were searched for eligible studies, and pooled effect sizes from eligible studies were calculated using random effect models. Furthermore, subgroups were established and meta-regression analyses were performed to explain the causes of heterogeneity. Eventually, nine studies with 3893 participants were included. Our statistical results suggested that the concentrations of peripheral CRP may be significantly increased for CD patients after stroke, compared to those of non-CD patients. Subgroup analyses showed that CRP was higher in CD than that in non-CD patients when the mini-mental state examination was used. A higher level of CRP in the acute phase of ischemic stroke may suggest an increased risk of CD after stroke. However, these results should be cautiously interpreted because of the limited sample sizes and the diversity of potential confounders in the studies included in this meta-analysis.
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Affiliation(s)
- Likun Wang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Lining Yang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Haiyan Liu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Juncai Pu
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Yi Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Lu Tang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Qing Chen
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Fang Pu
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China
| | - Dingqun Bai
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
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9
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Leng X, Wang D. Editorial: minor stroke is not minor. Stroke Vasc Neurol 2023; 8:175-177. [PMID: 36521937 PMCID: PMC10359791 DOI: 10.1136/svn-2022-002049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 11/09/2022] [Indexed: 12/23/2022] Open
Affiliation(s)
- Xinyi Leng
- Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - David Wang
- Barrow Neurological Institute Petznick Stroke Center, Phoenix, AZ, USA
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10
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Wu Y, Lv W, Li J, Yang X, Meng X, Li Z, Pan Y, Jiang Y, Yan H, Huang X, Liu L, Zhao X, Wang Y, Li H, Wang Y. High-Sensitivity C-Reactive Protein Modifies P-Wave Terminal Force in Lead V1-Associated Prognosis in Acute Ischemic Stroke or TIA Patients. J Clin Med 2023; 12:jcm12052031. [PMID: 36902819 PMCID: PMC10003915 DOI: 10.3390/jcm12052031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 02/26/2023] [Accepted: 03/01/2023] [Indexed: 03/08/2023] Open
Abstract
Little is known about the role of high-sensitivity C-reactive protein (hsCRP) in the relationship between P-wave terminal force in lead V1 (PTFV1) and stroke prognosis. We aimed to investigate how hsCRP influences the effect of PTFV1 on ischemic stroke recurrence and mortality. In this study, patients enrolled in the Third China National Stroke Registry, which enrolled consecutive patients who had suffered an ischemic stroke or transient ischemic attack in China, were analyzed. After excluding patients with atrial fibrillation, 8271 patients with PTFV1 and hsCRP measurements were included in this analysis. Cox regression analyses were used to assess the association between PTFV1 and stroke prognosis according to different inflammation statuses stratified by an hsCRP level of 3 mg/L. A total of 216 (2.6%) patients died, and 715 (8.6%) patients experienced ischemic stroke recurrence within 1 year. In patients with hsCRP levels ≥ 3 mg/L, elevated PTFV1 was significantly associated with mortality (HR, 1.75; 95% CI, 1.05-2.92; p = 0.03), while in those with hsCRP levels < 3 mg/L, such an association did not exist. In contrast, in patients with hsCRP levels < 3 mg/L and those with hsCRP levels ≥ 3 mg/L, elevated PTFV1 remained significantly associated with ischemic stroke recurrence. The predictive role of PTFV1 towards mortality but not ischemic stroke recurrence differed in terms of hsCRP levels.
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Affiliation(s)
- Yueyang Wu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing 100070, China
| | - Wei Lv
- China National Clinical Research Center for Neurological Diseases, Beijing 100070, China
| | - Jiejie Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing 100070, China
| | - Xiaomeng Yang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing 100070, China
| | - Xia Meng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing 100070, China
| | - Zixiao Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing 100070, China
| | - Yuesong Pan
- China National Clinical Research Center for Neurological Diseases, Beijing 100070, China
| | - Yong Jiang
- China National Clinical Research Center for Neurological Diseases, Beijing 100070, China
| | - Hongyi Yan
- China National Clinical Research Center for Neurological Diseases, Beijing 100070, China
| | - Xinying Huang
- China National Clinical Research Center for Neurological Diseases, Beijing 100070, China
| | - Liping Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing 100070, China
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing 100070, China
| | - Yilong Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing 100070, China
| | - Hao Li
- China National Clinical Research Center for Neurological Diseases, Beijing 100070, China
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing 100070, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100070, China
- Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing 100070, China
- Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai 200031, China
- Correspondence:
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11
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Hong G, Li T, Zhao H, Zeng Z, Zhai J, Li X, Luo X. Diagnostic value and mechanism of plasma S100A1 protein in acute ischemic stroke: a prospective and observational study. PeerJ 2023; 11:e14440. [PMID: 36643631 PMCID: PMC9838205 DOI: 10.7717/peerj.14440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 11/01/2022] [Indexed: 01/12/2023] Open
Abstract
Background Plasma S100A1 protein is a novel inflammatory biomarker associated with acute myocardial infarction and neurodegenerative disease's pathophysiological mechanisms. This study aimed to determine the levels of this protein in patients with acute ischemic stroke early in the disease progression and to investigate its role in the pathogenesis of acute ischemic stroke. Methods A total of 192 participants from hospital stroke centers were collected for the study. Clinically pertinent data were recorded. The volume of the cerebral infarction was calculated according to the Pullicino formula. Multivariate logistic regression analysis was used to select independent influences. ROC curve was used to analyze the diagnostic value of AIS and TIA. The correlation between S100A1, NF-κB p65, and IL-6 levels and cerebral infarction volume was detected by Pearson correlation analysis. Results There were statistically significant differences in S100A1, NF-κB p65, and IL-6 among the AIS,TIA, and PE groups (S100A1, [230.96 ± 39.37] vs [185.85 ± 43.24] vs [181.47 ± 27.39], P < 0.001; NF-κB p65, [3.99 ± 0.65] vs [3.58 ± 0.74] vs [3.51 ± 0.99], P = 0.001; IL-6, [13.32 ± 1.57] vs [11.61 ± 1.67] vs [11.42 ± 2.34], P < 0.001). Multivariate logistic regression analysis showed that S100A1 might be an independent predictive factor for the diagnosis of disease (P < 0.001). The AUC of S100A1 for diagnosis of AIS was 0.818 (P < 0.001, 95% CI [0.749-0.887], cut off 181.03, Jmax 0.578, Se 95.0%, Sp 62.7%). The AUC of S100A1 for diagnosis of TIA was 0.720 (P = 0.001, 95% CI [0.592-0.848], cut off 150.14, Jmax 0.442, Se 50.0%, Sp 94.2%). There were statistically significant differences in S100A1, NF-κB p65, and IL-6 among the SCI,MCI, and LCI groups (S100A1, [223.98 ± 40.21] vs [225.42 ± 30.92] vs [254.25 ± 37.07], P = 0.001; NF-κB p65, [3.88 ± 0.66] vs [3.85 ± 0.64] vs [4.41 ± 0.45], P < 0.001; IL-6, [13.27 ± 1.65] vs [12.77 ± 1.31] vs [14.00 ± 1.40], P = 0.007). Plasma S100A1, NF-κB p65, and IL-6 were significantly different from cerebral infarction volume (S100A1, r = 0.259, P = 0.002; NF-κB p65, r = 0.316, P < 0.001; IL-6, r = 0.177, P = 0.036). There was a positive correlation between plasma S100A1 and IL-6 with statistical significance (R = 0.353, P < 0.001). There was no significant positive correlation between plasma S100A1 and NF-κB p65 (R < 0.3), but there was statistical significance (R = 0.290, P < 0.001). There was a positive correlation between IL-6 and NF-κB p65 with statistical significance (R = 0.313, P < 0.001). Conclusion S100A1 might have a better diagnostic efficacy for AIS and TIA. S100A1 was associated with infarct volume in AIS, and its level reflected the severity of acute cerebral infarction to a certain extent. There was a correlation between S100A1 and IL-6 and NF-κB p65, and it was reasonable to speculate that this protein might mediate the inflammatory response through the NF-κB pathway during the pathophysiology of AIS.
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Affiliation(s)
- Guo Hong
- Department of Neurology, Second Clinical Medical College of Jinan University, Shenzhen, China
| | - Tingting Li
- Department of Neurology, Yizheng People’s Hospital affiliated to Yangzhou University, Yangzhou, China
| | - Haina Zhao
- Department of Neurology, Institutes of Brain Science, Jiangsu Subei People’s Hospital affiliated to Yangzhou University, Yangzhou, China
| | - Zhaohao Zeng
- Department of Neurology, Second Clinical Medical College of Jinan University, Shenzhen, China
| | - Jinglei Zhai
- School of Medicine, Southern University of Science and Technology, Shenzhen, China
| | - Xiaobo Li
- Department of Neurology, Institutes of Brain Science, Jiangsu Subei People’s Hospital affiliated to Yangzhou University, Yangzhou, China
| | - Xiaoguang Luo
- Department of Neurology, Second Clinical Medical College of Jinan University, Shenzhen, China
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12
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Limin Z, Alsamani R, Jianwei W, Yijun S, Dan W, Yuehong S, Ziwei L, Huiwen X, Dongzhi W, Xingquan Z, Guojun Z. The relationship of α-hydroxybutyrate dehydrogenase with 1-year outcomes in patients with intracerebral hemorrhage: A retrospective study. Front Neurol 2022; 13:906249. [PMID: 36330431 PMCID: PMC9623007 DOI: 10.3389/fneur.2022.906249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 09/23/2022] [Indexed: 11/13/2022] Open
Abstract
Background and aims Cardiac enzymes are recognized as a valuable tool for predicting the prognosis of various cardiovascular diseases. The prognostic value of alpha-hydroxybutyrate dehydrogenase (α-HBDH) in patients with intracerebral hemorrhage (ICH) was ambiguous and not evaluated. Methods Two hundred and thirteen Chinese patients with ICH participated in the study from December 2018 to December 2019. Laboratory routine tests and cardiac enzymes, including α-HBDH level, were examined and analyzed. All the patients were classified into two groups by the median value of α-HBDH: B1 <175.90 and B2 ≥175.90 U/L. The clinical outcomes included functional outcome (according to modified Rankin Scale (mRS) score ≥3), all-cause death, and recurrent cerebro-cardiovascular events 1 year after discharge. Associations between the α-HBDH and the outcomes were evaluated using logistic regression analysis. Univariate survival analysis was performed by the Kaplan-Meier method and log-rank test. Results Of the 213 patients, 117 had α-HBDH ≥175.90 U/L. Eighty-two patients had poor functional outcomes (mRS≥3). During the 1-year follow-up, a total of 20 patients died, and 15 of them had α-HBDH ≥175.90 U/L during the follow-up time. Moreover, 24 recurrent events were recorded. After adjusting confounding factors, α-HBDH (≥175.90) remained an indicator of poor outcome (mRS 3-6), all-cause death, and recurrent cerebro-cardiovascular events. The ORs for B2 vs. B1 were 4.78 (95% CI: 2.60 to 8.78, P = 0.001), 2.63 (95% CI: 0.80 to 8.59, P = 0.11), and 2.40 (95% CI: 0.82 to 7.02, P = 0.11) for poor functional outcomes with mRS ≥ 3, all-cause death, and recurrent cerebro-cardiovascular events, respectively. Conclusion Increased α-HBDH at admission was independently related to poor functional outcome and all-cause mortality in patients with ICH at 1-year follow-up.
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Affiliation(s)
- Zhang Limin
- Department of Clinical Diagnosis Laboratory of Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- NMPA Key Laboratory for Quality Control of In Vitro Diagnostics, Beijing, China
- Beijing Engineering Research Center of Immunological Reagents Clinical Research, Beijing, China
| | - Rasha Alsamani
- Department of Clinical Diagnosis Laboratory of Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- NMPA Key Laboratory for Quality Control of In Vitro Diagnostics, Beijing, China
- Beijing Engineering Research Center of Immunological Reagents Clinical Research, Beijing, China
| | - Wu Jianwei
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shi Yijun
- Department of Clinical Diagnosis Laboratory of Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- NMPA Key Laboratory for Quality Control of In Vitro Diagnostics, Beijing, China
- Beijing Engineering Research Center of Immunological Reagents Clinical Research, Beijing, China
| | - Wang Dan
- Department of Clinical Diagnosis Laboratory of Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- NMPA Key Laboratory for Quality Control of In Vitro Diagnostics, Beijing, China
- Beijing Engineering Research Center of Immunological Reagents Clinical Research, Beijing, China
| | - Sun Yuehong
- Department of Clinical Diagnosis Laboratory of Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- NMPA Key Laboratory for Quality Control of In Vitro Diagnostics, Beijing, China
- Beijing Engineering Research Center of Immunological Reagents Clinical Research, Beijing, China
| | - Liu Ziwei
- Department of Clinical Diagnosis Laboratory of Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- NMPA Key Laboratory for Quality Control of In Vitro Diagnostics, Beijing, China
- Beijing Engineering Research Center of Immunological Reagents Clinical Research, Beijing, China
| | - Xu Huiwen
- Department of Clinical Diagnosis Laboratory of Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- NMPA Key Laboratory for Quality Control of In Vitro Diagnostics, Beijing, China
- Beijing Engineering Research Center of Immunological Reagents Clinical Research, Beijing, China
| | - Wang Dongzhi
- Department of Clinical Diagnosis Laboratory of Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- NMPA Key Laboratory for Quality Control of In Vitro Diagnostics, Beijing, China
- Beijing Engineering Research Center of Immunological Reagents Clinical Research, Beijing, China
| | - Zhao Xingquan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhang Guojun
- Department of Clinical Diagnosis Laboratory of Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- NMPA Key Laboratory for Quality Control of In Vitro Diagnostics, Beijing, China
- Beijing Engineering Research Center of Immunological Reagents Clinical Research, Beijing, China
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13
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Banait T, Wanjari A, Danade V, Banait S, Jain J. Role of High-Sensitivity C-reactive Protein (Hs-CRP) in Non-communicable Diseases: A Review. Cureus 2022; 14:e30225. [PMID: 36381804 PMCID: PMC9650935 DOI: 10.7759/cureus.30225] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
Non-communicable diseases like cardiovascular diseases, cerebrovascular diseases, diabetes mellitus, and cancer are very common causes of death worldwide. Therefore, the need to search for novel, affordable, and easily accessible biomarkers and risk factors for non-communicable diseases continues, which can predict the future risk of having these diseases with greater accuracy and precision. In this context, among available biomarkers, high-sensitivity C-reactive protein (Hs-CRP) is considered to be the best-suited marker. Various drug intervention trials demonstrated positive results in reducing Hs-CRP in individuals with raised levels. Numerous pharmacological and non-pharmacologic interventions in the form of lifestyle modifications, exercise, and cessation of smoking are being investigated to study their effect on reducing serum C-reactive protein (CRP) levels. This review article discusses the role of Hs-CRP and its isoforms in the pathogenesis of various disease conditions, factors affecting its serum concentration, its prognostic value, and its comparison with other risk factors. Further, its clinical significance in chronic inflammatory and degenerative diseases of the nervous system and other common non-communicable diseases, including recent advances in the management of various diseases, has also been discussed.
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14
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Yuan B, Meng X, Wang A, Niu S, Xie X, Jing J, Li H, Chang L, Wang Y, Li J. Effect of different doses of colchicine on high sensitivity C-reactive protein in patients with acute minor stroke or transient ischemic attack: A pilot randomized controlled trial. Eur J Pharm Sci 2022; 178:106288. [PMID: 36041708 DOI: 10.1016/j.ejps.2022.106288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 08/22/2022] [Accepted: 08/26/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND AND PURPOSE Patients with elevated levels of high-sensitivity C-reactive protein (hsCRP) are at increased risk of recurrent stroke. Colchicine is a unique anti-inflammatory medication that has shown promise in reducing cardiovascular event. The current study mainly tested the ability of colchicine at different doses to reduce hsCRP levels after stroke. METHODS This was a randomized controlled and open label trial. Eligible patients with acute minor ischemic stroke or transient ischemic attack (TIA) were randomized within 24 hours after symptom onset in a 1:1:1:1 ratio to four groups with different doses of colchicine. Group 1: 0.5 mg of colchicine per day for 14 days; groups 2: starting with 1mg of colchicine on days 1 through 7, and maintaining with 0.5 mg per day on days 8 through 14; group 3 and 4: respectively 2 mg and 3 mg of colchicine on day 1, following with 1mg per day on days 2 through 7 and continuing with 0.5 mg per day on days 8 through 14. Blood specimens were collected at randomization, 24 hours, 72 hours, 7 days and 14 days after index event for hsCRP measurements. The primary outcome was the change of hsCRP levels between baseline and 14 days. RESULTS A total of 39 patients were enrolled. Patients in group 2 had reduced level of hsCRP at 14-day compared with baseline value (p=0.005). Time-course analyses showed that patients in groups of 1 and 2 had lower hsCRP level at 7-day than that at baseline, and patients in groups of 1, 2 and 3 had lower ratios of hsCRP levels at 72 hours to those at baseline. Low dose of colchicine was well tolerated without discontinuation of drug. CONCLUSION Early treatment with low dose of colchicine reduced hsCRP levels in the patients with acute minor ischemic stroke and TIA.
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Affiliation(s)
- Baoshi Yuan
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Xia Meng
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Anxin Wang
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Siying Niu
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Xuewei Xie
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Jing Jing
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Hao Li
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Liguo Chang
- Third People's Hospital of Liaocheng, Shandong, China
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, 2019RU018, Beijing, China; Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Beijing, China
| | - Jiejie Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China.
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15
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Tian Y, Pan Y, Yan H, Meng X, Zhao X, Liu L, Wang Y, Wang Y. Coexistent cerebral small vessel disease and multiple infarctions predict recurrent stroke. Neurol Sci 2022; 43:4863-4874. [PMID: 35364769 PMCID: PMC9349065 DOI: 10.1007/s10072-022-06027-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 03/18/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND AND PURPOSE To investigate the association of different status of cerebral small vessel disease (CSVD) and infarction number with recurrence after acute minor stroke and transient ischaemic attack (TIA). METHODS This study was a post hoc analysis of the Clopidogrel in High-risk Patients with Acute Nondisabling Cerebrovascular Events (CHANCE) trial, and includes 886 patients with acute minor stroke and TIA. The status of CSVD and infarction number was recorded for each individual. Infarction number were classified as multiple acute infarctions (MAIs≥2), single acute infarction (SAI =1), and non-acute infarction (NAI =0). The CSVD burden were grouped into non-CSVD (0 score) and CSVD (1-4 score). The primary outcome was a recurrent stroke at the 1-year follow-up. The secondary outcomes were recurrent ischaemic stroke, composite vascular event (CVE), and TIA. We analyzed the relationships between different status of CSVD burden and infarction pattern with the risk of outcomes using multivariable Cox regression models. RESULTS Among all 886 patients included in present analysis, recurrent stroke was occurred in 93 (10.5%) patients during 1-year follow-up. After adjusted for all potential covariates, compared with patients with non-CSVD and NAI, patients with CSVD and MAIs were associated with approximately 9.5-fold increased risk of recurrent stroke at 1 year (HR 9.560, 95% CI 1.273-71.787, p=0.028). Similar results observed in ischaemic stroke and CVE. CONCLUSION The status of CSVD and infarction number predicted recurrent stroke in patients with acute minor stroke and TIA, especially for those with coexistent CSVD and MAIs.
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Affiliation(s)
- Yu Tian
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- Chinese Institute for Brain Research, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
| | - Yuesong Pan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- Chinese Institute for Brain Research, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
| | - Hongyi Yan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- Chinese Institute for Brain Research, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
| | - Xia Meng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- Chinese Institute for Brain Research, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
| | - XingQuan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- Chinese Institute for Brain Research, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
| | - Liping Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- Chinese Institute for Brain Research, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- Chinese Institute for Brain Research, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
| | - Yilong Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China.
- Chinese Institute for Brain Research, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China.
- China National Clinical Research Center for Neurological Diseases, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China.
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China.
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China.
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16
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Wang G, Yang X, Jing J, Zhao X, Liu L, Wang C, Wang D, Wang A, Meng X, Wang Y, Wang Y. Clopidogrel Plus Aspirin in Patients With Different Types of Single Small Subcortical Infarction. Front Neurol 2021; 12:631220. [PMID: 33854474 PMCID: PMC8039512 DOI: 10.3389/fneur.2021.631220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 02/05/2021] [Indexed: 11/13/2022] Open
Abstract
Background: We aim to investigate the effects and safety of clopidogrel plus aspirin in patients with different types of single small subcortical infarction (SSSI) in the Clopidogrel in High-risk patients with Acute Non-disabling Cerebrovascular Events (CHANCE) trial. Methods: SSSI was defined as single DWI lesion of ≤2.0 cm. Patients with SSSI were divided into SSSI + PAD (parent artery disease) and SSSI - PAD, according to the stenosis of the parent artery. The efficacy outcome was stroke recurrence during 90-day follow-up. Cox proportional hazards models or logistic regression models were used to assess the interaction of the treatment effects of clopidogrel plus aspirin vs. aspirin alone among patients with and without PAD. Results: Among 338 patients with SSSI included in the subanalysis, 105 were with PAD and 233 without. The efficacy of clopidogrel plus aspirin compared with aspirin alone on any stroke was consistent between patients with [adjusted hazard ratio (HR) 0.84; 95% confidence interval (CI), 0.25-2.75] and without PAD (adjusted HR 1.03; 95% CI, 0.40-2.68, interaction P = 0.83). In patients with SSSI + PAD, the rate of stroke recurrence in those treated with dual antiplatelet therapy and mono antiplatelet therapy was not significantly different (10.9 vs. 13.6%, P = 0.77). The number of bleeding events was similar between the clopidogrel-aspirin group and aspirin group regardless of SSSI + PAD or SSSI - PAD. Conclusions: There was no significant difference in the efficacy of clopidogrel plus aspirin compared with aspirin alone between patients with SSSI + PAD and SSSI - PAD in the CHANCE trial. Studies in other populations and with adequate power are needed to further verify such findings.
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Affiliation(s)
- Guangyao Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Xiaomeng Yang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Jing Jing
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Liping Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Chunxue Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - David Wang
- Neurovascular Division, Department of Neurology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Xia Meng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yilong Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
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