RT Journal Article
SR Electronic
T1 Endothelial and leukocyte-derived microvesicles and cardiovascular risk after stroke—PROSCIS-B
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 10.1212/WNL.0000000000011223
DO 10.1212/WNL.0000000000011223
A1 Huo, Shufan
A1 Kränkel, Nicolle
A1 Nave, Alexander Heinrich
A1 Sperber, Pia Sophie
A1 Rohmann, Jessica Lee
A1 Piper, Sophie Käthe
A1 Heuschmann, Peter
A1 Landmesser, Ulf
A1 Endres, Matthias
A1 Siegerink, Bob
A1 Liman, Thomas Günter Gerhard
YR 2020
UL http://n.neurology.org/content/early/2020/11/12/WNL.0000000000011223.abstract
AB Objective To determine the role of circulating microvesicles (MV) on long-term cardiovascular outcomes after stroke, we measured them in first-ever stroke patients with a three-year follow-up.Methods In the PROSpective Cohort with Incident Stroke Berlin (PROSCIS-B), patients with first-ever ischemic stroke were followed for 3 years. The primary combined endpoint consisted of recurrent stroke, myocardial infarction, and all-cause mortality. Citrate-blood levels of endothelial MV (EMV), leukocyte-derived MV (LMV), monocytic MV (MMV), and platelet-derived MV (PMV) were measured using flow cytometry. Kaplan-Meier curves and adjusted Cox proportional hazards models were used to estimate the effect of MV levels on the combined endpoint.Results Five hundred seventy-one patients were recruited (median age 69 years; 39% female; median NIHSS 2, interquartile range 1–4) and 95 endpoints occurred. Patients with levels of EMV [adjusted hazard ratio (HR) = 2.5, 95% confidence interval (CI) 1.2–4.9] or LMV (HR = 3.1, 95% CI 1.4–6.8) in the highest quartile were more likely to experience an event than participants with lower levels using the lowest quartile as reference category. The association was less pronounced for PMV (HR = 1.7, 95% CI 0.9–3.2) and absent for MMV (HR = 1.1, 95% CI 0.6–1.8).Conclusion High levels of EMV and LMV after stroke were associated with worse cardiovascular outcome within 3 years. These results reinforce that endothelial dysfunction and vascular inflammation affect the long-term prognosis after stroke. EMV and LMV might play a role in risk prediction for stroke patients.Study registration clinicaltrials.gov/ct2/show/NCT01363856. UID: NCT01363856.Classification of evidence This study provides Class II evidence of the impact of MV levels on subsequent stroke, myocardial infarction or all-cause mortality in survivors of mild stroke.