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Homocysteine and C-Reactive Protein Associated with Progression and Prognosis of Intracranial Branch Atheromatous Disease
BACKGROUND AND OBJECTIVES: C-reactive protein (CRP) is a biomarker of inflammation and a sensitive predictor of stroke, and high homocysteine (Hcy) is also associated with stroke. However, the roles of CRP and Hcy in the pathogenesis, progression and prognosis of branch atheromatous disease (BAD) an...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3770607/ https://www.ncbi.nlm.nih.gov/pubmed/24039853 http://dx.doi.org/10.1371/journal.pone.0073030 |
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author | Men, Xuejiao Li, Jiejie Zhang, Bingjun Zhang, Lei Li, Haiyan Lu, Zhengqi |
author_facet | Men, Xuejiao Li, Jiejie Zhang, Bingjun Zhang, Lei Li, Haiyan Lu, Zhengqi |
author_sort | Men, Xuejiao |
collection | PubMed |
description | BACKGROUND AND OBJECTIVES: C-reactive protein (CRP) is a biomarker of inflammation and a sensitive predictor of stroke, and high homocysteine (Hcy) is also associated with stroke. However, the roles of CRP and Hcy in the pathogenesis, progression and prognosis of branch atheromatous disease (BAD) and lipohyalinotic degeneration (LD) are largely unknown. We sought to determine the relation between them in Chinese patients. METHODS: According to the lesion presences shown by diffusion-weighted imaging (DWI), we retrospectively recruited a cohort of 308 patients with a diagnosis of BAD and LD from a total of 1458 consecutive patients with acute ischemic stroke. Progression was defined as worsening by > or = 1-point in the NIHSS for motor function within the first 5 days. Good outcome was deemed as Modified Rankin Scale (mRS) ≤ 2 and poor outcome was mRS > 2 recorded at one month after onset. RESULTS: This study comprised a total of 179 patients with BAD and 129 patients with LD. Subjects in patients with LD significantly had an elevated Hcy (p = 0.030), a lower NIHSS score on admission (p<0.001) and mRS score at one month after ictus (p<0.001) than those in patients with BAD. Elevated Hcy (P = 0.004) and increased CRP (P = 0.025) were associated with progression in patients with BAD, and CRP (p = 0.006) and diabetes mellitus (p = 0.011) were found to be associated with poor outcome in patients with BAD. However, no association was observed in patients with LD on progression and prognosis. After multivariate logistic regression analysis, elevated Hcy (p = 0.002) remained the only independent predictor for the progression, and increased CRP (p = 0.027) and smoking (p = 0.012) became the independent predictors for the poor outcome in patients with BAD. CONCLUSIONS: In patients with BAD, elevated Hcy and increased CRP may independently predict progression and prognosis, respectively. |
format | Online Article Text |
id | pubmed-3770607 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-37706072013-09-13 Homocysteine and C-Reactive Protein Associated with Progression and Prognosis of Intracranial Branch Atheromatous Disease Men, Xuejiao Li, Jiejie Zhang, Bingjun Zhang, Lei Li, Haiyan Lu, Zhengqi PLoS One Research Article BACKGROUND AND OBJECTIVES: C-reactive protein (CRP) is a biomarker of inflammation and a sensitive predictor of stroke, and high homocysteine (Hcy) is also associated with stroke. However, the roles of CRP and Hcy in the pathogenesis, progression and prognosis of branch atheromatous disease (BAD) and lipohyalinotic degeneration (LD) are largely unknown. We sought to determine the relation between them in Chinese patients. METHODS: According to the lesion presences shown by diffusion-weighted imaging (DWI), we retrospectively recruited a cohort of 308 patients with a diagnosis of BAD and LD from a total of 1458 consecutive patients with acute ischemic stroke. Progression was defined as worsening by > or = 1-point in the NIHSS for motor function within the first 5 days. Good outcome was deemed as Modified Rankin Scale (mRS) ≤ 2 and poor outcome was mRS > 2 recorded at one month after onset. RESULTS: This study comprised a total of 179 patients with BAD and 129 patients with LD. Subjects in patients with LD significantly had an elevated Hcy (p = 0.030), a lower NIHSS score on admission (p<0.001) and mRS score at one month after ictus (p<0.001) than those in patients with BAD. Elevated Hcy (P = 0.004) and increased CRP (P = 0.025) were associated with progression in patients with BAD, and CRP (p = 0.006) and diabetes mellitus (p = 0.011) were found to be associated with poor outcome in patients with BAD. However, no association was observed in patients with LD on progression and prognosis. After multivariate logistic regression analysis, elevated Hcy (p = 0.002) remained the only independent predictor for the progression, and increased CRP (p = 0.027) and smoking (p = 0.012) became the independent predictors for the poor outcome in patients with BAD. CONCLUSIONS: In patients with BAD, elevated Hcy and increased CRP may independently predict progression and prognosis, respectively. Public Library of Science 2013-09-11 /pmc/articles/PMC3770607/ /pubmed/24039853 http://dx.doi.org/10.1371/journal.pone.0073030 Text en © 2013 Men et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Men, Xuejiao Li, Jiejie Zhang, Bingjun Zhang, Lei Li, Haiyan Lu, Zhengqi Homocysteine and C-Reactive Protein Associated with Progression and Prognosis of Intracranial Branch Atheromatous Disease |
title | Homocysteine and C-Reactive Protein Associated with Progression and Prognosis of Intracranial Branch Atheromatous Disease |
title_full | Homocysteine and C-Reactive Protein Associated with Progression and Prognosis of Intracranial Branch Atheromatous Disease |
title_fullStr | Homocysteine and C-Reactive Protein Associated with Progression and Prognosis of Intracranial Branch Atheromatous Disease |
title_full_unstemmed | Homocysteine and C-Reactive Protein Associated with Progression and Prognosis of Intracranial Branch Atheromatous Disease |
title_short | Homocysteine and C-Reactive Protein Associated with Progression and Prognosis of Intracranial Branch Atheromatous Disease |
title_sort | homocysteine and c-reactive protein associated with progression and prognosis of intracranial branch atheromatous disease |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3770607/ https://www.ncbi.nlm.nih.gov/pubmed/24039853 http://dx.doi.org/10.1371/journal.pone.0073030 |
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