■在高危卒中人群中,确定参与炎症和内皮功能以及颈动脉粥样硬化的基因中19个单核苷酸多态性(SNP)与随后的缺血性卒中和其他血管事件的关联。
■这是一项基于四川省多中心社区的局部调查和前瞻性队列研究,中国西南部。随机选择了八个社区,并使用结构化的面对面问卷对每个社区的居民进行了调查。从属于高危卒中人群的2,893人中的2,377人获得了颈动脉超声检查和DNA信息。测量涉及炎症和内皮功能的基因中的19个SNP的基因型。在面对面调查后,所有2377名受试者都接受了4.7年的随访。主要结果是缺血性卒中,次要结局是血管事件的复合结局.
■在2,377名受试者中,2,205(92.8%)完成了4.7年的随访,947例(42.9%)颈动脉粥样硬化[372例(16.9%)颈动脉易损斑块,405(18.4%)平均IMT>0.9mm,285(12.0%)颈动脉狭窄≥15%]。结果发生在158(7.2%)受试者[92(4.2%)缺血性卒中,17例(0.8%)出血性中风,48(2.2%)心肌梗死,随访期间死亡26例(1.2%)]。在19个SNP中,ITGA2rs1991013,IL1Ars1609682和HABP2rs7923349之间存在显着的基因-基因相互作用。多因素logistic回归模型显示,颈动脉粥样硬化和三个SNPs中的高危交互基因型独立于缺血性卒中的高风险(OR=2.67,95%CI:1.52-6.78,p=0.004;OR=3.11,95%CI:2.12-9.27,p<0.001)和复合血管事件(OR=3.04,95%CI:1.46-6.35,p<0.001);
■在高危卒中人群中,颈动脉粥样硬化的患病率很高。特定SNPs,他们之间的互动,颈动脉粥样硬化与缺血性卒中和其他血管事件的高风险独立相关。
UNASSIGNED: To identify the associations of 19 single nucleotide polymorphisms (SNPs) in genes involved in inflammation and endothelial function and carotid atherosclerosis with subsequent ischemic stroke and other vascular events in the high-risk stroke population.
UNASSIGNED: This was a multicenter community-based sectional survey and prospective cohort study in Sichuan, southwestern
China. Eight communities were randomly selected, and the residents in each community were surveyed using a structured face-to-face questionnaire. Carotid ultrasonography and DNA information were obtained from 2,377 out of 2,893 individuals belonging to a high-risk stroke population. Genotypes of the 19 SNPs in genes involved in inflammation and endothelial function were measured. All the 2,377 subjects were followed up for 4.7 years after the face-to-face survey. The primary outcome was ischemic stroke, and the secondary outcome was a composite of vascular events.
UNASSIGNED: Among the 2,377 subjects, 2,205 (92.8%) completed a 4.7-year follow-up, 947 (42.9%) had carotid atherosclerosis [372 (16.9%) carotid vulnerable plaque, 405 (18.4%) mean IMT > 0.9 mm, 285 (12.0%) carotid stenosis ≥15%]. Outcomes occurred in 158 (7.2%) subjects [92 (4.2%) ischemic stroke, 17 (0.8%) hemorrhagic stroke, 48 (2.2%) myocardial infarction, and 26 (1.2%) death] during follow-up. There was a significant gene-gene interaction among ITGA2 rs1991013, IL1A rs1609682, and HABP2 rs7923349 in the 19 SNPs. The multivariate logistic regression model revealed that carotid atherosclerosis and the high-risk interactive genotypes among the three SNPs were independent with a higher risk for ischemic stroke (OR = 2.67, 95% CI: 1.52-6.78, p = 0.004; and OR = 3.11, 95% CI: 2.12-9.27, p < 0.001, respectively) and composite vascular events (OR = 3.04, 95% CI: 1.46-6.35, p < 0.001; and OR = 3.23, 95% CI: 1.97-8.52, p < 0.001, respectively).
UNASSIGNED: The prevalence of carotid atherosclerosis was shown to be very high in the high-risk stroke population. Specific SNPs, interactions among them, and carotid atherosclerosis were independently associated with a higher risk of ischemic stroke and other vascular events.