Stroke: Stroke, residual inflammatory factors themselves, can effectively predict recurrence of stroke

For stroke patients, although low-density lipoprotein cholesterol (LDL-C) is currently clinically actively reduced , patients still have recurrent vascular events
.

Inflammation may be an important factor in causing this residual risk
.

Early clinical trials have proven the effectiveness of primary prevention against residual inflammatory risk (RIR)
.

In addition, a recent study showed that anti-inflammatory treatments have a protective effect on cardiovascular disease, but have no effect on low-density lipoprotein cholesterol levels
.

As a determinant of RIR, high-sensitivity C-reactive protein (hsCRP) is considered to be at least as important as LDL-C and is a determinant of residual cholesterol risk (RCR)
.

In this way, Jiejie Li and others of Tiantan Hospital used the Third China National Stroke Registry (CNSR-III), a prospective multicenter cohort study: a total of 10,499 consecutive acute ischemic strokes and transient brains were included.
Patients with ischemic attack, and tested the levels of LDL-C and hsCRP
.

Patients were divided into 4 groups: residual cholesterol risk only (LDL-C≥2.
6 mmol/L and hsCRP <3 mg/L), residual inflammation risk (RIR) only (LDL-C <2.
6 mmol/L and hsCRP≥3 mg /L), both risks are present (LDL-C≥2.
6 mmol/L and hsCRP≥3 mg/L), and neither risk (LDL-C <2.
6 mmol/L and hsCRP<3 mg/L)
.

Main outcome: Stroke recurrence and a modified Rankin scale score of 2 to 6 within 1 year
.

They found that the relative proportions of patients with only RIR, only residual cholesterol risk, two risks, and neither of them were 21.
3%, 23.
7%, 14.
4%, and 40.
6%, respectively
.

Only RIR was independently associated with recurrent stroke (adjusted hazard ratio, 1.
18 [95% CI, 1.
00-1.
40]; P=0.
05)
.

In addition to traditional risk factors, after further adjusting the use of antiplatelet drugs and statins during the 1-year follow-up period, this association weakened slightly (HR=1.
31 [95% CI, 0.
99-1.
76]; P=0.
07)
.

Patients with only RIR also have an increased risk of adverse functional outcomes (HR=1.
43 [95% CI, 1.
24-1.
64]; P<0.
0001)
.

The significance of this study is to find that in patients with acute ischemic stroke or transient ischemic attack, only RIR can predict recurrent stroke, especially those with large atherosclerosis, and adverse functional outcomes
.

Original source:
Li J, Pan Y, Xu J, et al.