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高血清C反应蛋白水平不是中风的独立预测因素:鹿特丹研究

Michiel J Bos¹, C Maarten A Schipper, Peter J Koudstaal

¹Department of Epidemiology and Biostatistics, Erasmus Medical Center, PO Box 1738, 3000 DR Rotterdam, The Netherlands.

|October 4, 2006

概括

高C反应蛋白 (CRP) 水平与中风风险增加有关,但不能改善个人中风风险预测. 这一发现影响了心血管风险评估策略.

科学领域:

心脏病学心脏病学
神经学神经学
生物标志物生物标志物

背景情况:

目前的指导方针建议高灵敏度C反应蛋白 (hs-CRP) 用于心血管风险预测.
新出现的证据质疑CRP的预测价值,尽管它与心血管疾病有关.
这项研究调查了CRP作为未来中风风险因素和预测因素的作用.

研究的目的:

为了确定C反应性蛋白 (CRP) 水平是否与未来中风风险有关.
评估CRP在预测个人中风风险方面的有用性.

主要方法:

利用了6430名参与者 (年龄≥55,在基线上没有中风) 在鹿特丹研究 (1990-1993) 中的数据.
评估中风风险变化与基线CRP血清水平使用Cox比例危险模型.
通过接收器运行特征曲线评估CRP对个人中风风险的预测准确性.

主要成果:

在8.2年的时间里,发生了498次首次中风.
升高的CRP水平与任何中风 (HR 1.14) 和缺血性中风 (HR 1.17) 的风险有显著关联.
纳入CRP水平并没有提高个体中风风险预测的准确性,即使与像Framingham中风风险得分这样的既定得分相结合.

结论:

有证据表明,C-反应蛋白 (CRP) 水平与中风风险增加有关.
在评估个人中风风险方面,CRP的临床实用性似乎有限.
可能需要进一步的研究来澄清CRP在中风风险分层中的作用.

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