Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease

Laboratory of, China

Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease

Laboratory of, China
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Liu Y.,Capital Medical University | Wang Y.,Capital Medical University | Wang Y.,China National Clinical Research Center for Neurological Diseases | Wang Y.,Beijing Institute for Brain Disorders | And 4 more authors.
Neurological Research | Year: 2017

Objective: Predictive scores are important tools for stratifying patients based on their risk of future vascular events and for selecting preventive therapies. The aim of this study is to validate the Essen Stroke Risk Score (ESRS) for stratifying stroke recurrence in different subtypes of non-atrial fibrillation ischemic stroke in a large Chinese cohort. Methods: Data were derived from the Blood pressure and clinical Outcome in Stroke Survivors registry, which includes a cohort of 2204 stroke patients. All patients were further classified according to the TOAST (Trial of Org 10 172 in Acute Stroke Treatment) criteria. We stratified one-year cumulative rates for stroke and composite vascular events using the ESRS. The predictive power of the ESRS was assessed using the area under the receiver–operator curves (AUC). Results: Among 1699 patients included in the study, the AUC of ESRS was 0.58 (95% CI: 0.52–0.64) for recurrent stroke, whereas 0.59 (95% CI: 0.53–0.64) for composite vascular events at 1 year. In patients with large-artery atherosclerosis (LAA) subtype of stroke, the AUC of ESRS was both 0.61 (95% CI: 0.54–0.68) for recurrent stroke and composite vascular events. However, no significant AUC was observed in patients with small-artery occlusion subtype of stroke. Conclusions: In patients with LAA subtype of non-atrial fibrillation stroke, the ESRS has moderate accuracy in stratifying the risk of both recurrent strokes and major vascular events within the first year. However, the ESRS couldn’t accurately stratify the risk of recurrent strokes in patients with small-artery atherosclerosis subtype of non-atrial fibrillation stroke. © 2017 Informa UK Limited, trading as Taylor & Francis Group


Wang Y.,Capital Medical University | Wang Y.,China National Clinical Research Center for Neurological Diseases | Li Z.,China National Clinical Research Center for Neurological Diseases | Li Z.,Capital Medical University | And 9 more authors.
International Journal of Stroke | Year: 2017

Stroke is the leading cause of death and adult disability in China. Although evidence-based clinical interventions have been identified to improve care and outcomes in stroke, significant gaps still exist between guideline recommendations and clinical practice in China. Regional and national stroke registries have been used to assess the benchmark of stroke care quality, provide feedback on compliance with evidence-based performance measures to health care providers, and continuously improve stroke care quality without increasing additional medical costs in the past several decades worldwide. In China, stroke care has become a national priority. A series of stroke care quality assessment and improvement actions was initiated by the Ministry of Health to increase the detection of high-risk populations with stroke, rate of adherence to evidence-based process performance measures of stroke care, and stroke care organization development, aiming to decrease the burden of stroke. China National Stroke Registries have been started in 2007, and they are conducted every 3 to 5 years. A carotid disease screen and intervention project for communities was initiated in 2009. The Chinese Stroke Association, founded in 2015, launched the Chinese Stroke Center Alliance to increase the stroke center design in the near future. In this article, we described these stroke care actions and progression, summarized the benchmark and improvement of stroke care quality, and outlined the future plans in China. © 2017, © 2017 World Stroke Organization.


Li J.,Capital Medical University | Wang Y.,Capital Medical University | Lin J.,Capital Medical University | Wang D.,University of Illinois at Urbana - Champaign | And 7 more authors.
Stroke | Year: 2015

Background and Purpose-Elevated soluble CD40 ligand (sCD40L) was shown to be related to cardiovascular events, but the role of sCD40L in predicting recurrent stroke remains unclear. Methods-Baseline sCD40L levels were measured in 3044 consecutive patients with acute minor stroke and transient ischemic attack, who had previously been enrolled in the Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events (CHANCE) trial. Cox proportional-hazards model was used to assess the association of sCD40L with recurrent stroke. Results-Patients in the top tertile of sCD40L levels had increased risk of recurrent stroke comparing with those in the bottom tertile, after adjusted for conventional confounding factors (hazard ratio, 1.49; 95% confidence interval, 1.11-2.00; P=0.008). The patients with elevated levels of both sCD40L and high-sensitive C-reactive protein also had increased risk of recurrent stroke (hazard ratio, 1.81; 95% confidence interval, 1.23-2.68; P=0.003). Conclusions-Elevated sCD40L levels independently predict recurrent stroke in patients with minor stroke and transient ischemic attack. © 2015 American Heart Association, Inc.


Wang Y.,Capital Medical University | Wang Y.,China National Clinical Research | Yang X.,Capital Medical University | Li Z.,Capital Medical University | And 11 more authors.
Stroke | Year: 2016

Background and Purpose-Guidelines recommend oral anticoagulation for ischemic stroke patients with atrial fibrillation, and previous studies have shown the underuse of anticoagulation for these patients in China. We sought to explore the underlying reasons and factors that currently affect the use of warfarin in China. Methods-From June 2012 to January 2013, 19 604 patients with acute ischemic stroke were admitted to 219 urban hospitals voluntarily participating in the China National Stroke Registry II. Multivariable logistic regression models using the generalized estimating equation method were used to identify patient/hospital factors independently associated with warfarin use at discharge. Results-Among the 952 acute ischemic stroke patients with nonvalvular atrial fibrillation, 19.4% were discharged on warfarin. The risk of bleeding (52.8%) and patient refusal (31.9%) were the main reasons for not prescribing anticoagulation. Larger/teaching hospitals were more likely to prescribe warfarin. Older patients, heavy drinkers, patients with higher National Institutes of Health Stroke Scale score on admission were less likely to be given warfarin, whereas patients with history of heart failure and an international normalized ratio between 2.0 and 3.0 during hospitalization were significantly associated with warfarin use at discharge. Conclusions-The rate of warfarin use remains low among patients with ischemic stroke and known nonvalvular atrial fibrillation in China. Hospital size and academic status together with patient age, heart failure, heavy alcohol drinking, international normalized ratio in hospital, and stroke severity on admission were each independently associated with the use of warfarin at discharge. There is much room for improvement for secondary stroke prevention in nonvalvular atrial fibrillation patients in China. © 2016 American Heart Association, Inc.


Wang Y.,Capital Medical University | Wang Y.,China National Clinical Research Center for Neurological Diseases | Wang Y.,Beijing Institute for Brain Disorders | Wang Y.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease | And 4 more authors.
Current Cardiology Reports | Year: 2015

Stroke is a major public health concern worldwide, and 25 % of stroke victims would have another stroke. Although administration of antiplatelet agents has been confirmed to be one of the major approaches for secondary prevention of noncardioembolic stroke, the short-term or long-term use of aspirin plus clopidogrel for secondary stroke prevention remains to be controversial. This article aims at providing a comprehensive review of the evidence on the use of aspirin plus clopidogrel for secondary stroke prevention, with special focus on important studies that may impact clinical practice of treating patients with stroke or transient ischemic attack. © 2015, Springer Science+Business Media New York.


Li J.,Capital Medical University | Li J.,China National Clinical Research Center for Neurological Diseases | Li J.,Beijing Institute for Brain Disorders | Li J.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease | And 4 more authors.
Neuroscience Bulletin | Year: 2016

Minor stroke and transient ischemic attack (TIA) are common disorders with a high rate of subsequent disabling stroke, so the early recognition and management of minor stroke and TIA is of great importance. At the moment, the diagnosis of these disorders is based on neurologic deficits in a stroke-clinician’s examination of the patient, supplemented by the results of acute brain imaging. However, high variability in TIA diagnosis has been reported between physicians, even trained vascular neurologists, and image-based diagnostic confirmation is not always readily available. Some patients still have ischemic events despite sustained standard secondary preventive therapy. Blood biomarkers are promising to aid in the diagnosis, risk stratification, and individual treatment of minor stroke and TIA. Some studies are being conducted in this field. This mini-review aims to highlight potential biomarkers for diagnosis and those helpful in predicting the risk of future stroke and the selection of treatment. © 2016 Shanghai Institutes for Biological Sciences, CAS and Springer Science+Business Media Singapore


Wang Y.,Capital Medical University | Wang Y.,China National Clinical Research Center for Neurological Diseases | Wang Y.,Beijing Institute for Brain Disorders | Wang Y.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease | And 30 more authors.
Circulation | Year: 2015

Background-The Clopidogrel in High-risk patients with Acute Non-disabling Cerebrovascular Events (CHANCE) trial showed that the combined treatment of clopidogrel and aspirin decreases the 90-day risk of stroke without increasing hemorrhage in comparison with aspirin alone, but provided insufficient data to establish whether the benefit persisted over a longer period of time beyond the trial termination. We report the 1-year follow-up outcomes of this trial. Methods and Results-The trial was a randomized, double-blind, placebo-controlled trial conducted at 114 centers in China. We randomly assigned 5170 patients within 24 hours after onset of minor stroke or high-risk transient ischemic attack to clopidogrel-aspirin therapy (loading dose of 300 mg of clopidogrel on day 1, followed by 75 mg of clopidogrel per day for 90 days, plus 75 mg of aspirin per day for the first 21 days) or to the aspirin-alone group (75 mg/d for 90 days). The primary outcome was stroke event (ischemic or hemorrhagic) during 1-year follow-up. Differences in outcomes between groups were assessed by using the Cox proportional hazards model. Stroke occurred in 275 (10.6%) patients in the clopidogrel-aspirin group, in comparison with 362 (14.0%) patients in the aspirin group (hazard ratio, 0.78; 95% confidence interval, 0.65-0.93; P=0.006). Moderate or severe hemorrhage occurred in 7 (0.3%) patients in the clopidogrel-aspirin group and in 9 (0.4%) patients in the aspirin group (P=0.44). Conclusions-The early benefit of clopidogrel-aspirin treatment in reducing the risk of subsequent stroke persisted for the duration of 1-year of follow-up. © 2015 American Heart Association, Inc.


Yuan C.-X.,Capital Medical University | Chu T.,University of Calgary | Liu L.,Capital Medical University | Li H.-W.,Capital Medical University | And 6 more authors.
American Journal of Translational Research | Year: 2015

In demyelinating diseases such as multiple sclerosis, one of the treatment strategies includes remyelination using oligodendrocyte precursor cells (OPC). Catalpol, the extract of radix rehmanniae, is neuroprotective. Using an OPC culture model, we showed that 10 μM catalpol promotes OPC proliferation, cell migration and differentiation into mature oligodendrocytes. The 10 μM catalpol displayed stronger effects on OPCs migration and oligodendrocyte differentiation. These results suggest that catalpol has a potential role in promoting remyelination in demyelinating diseases, and is of therapeutic interest. © 2015, E-Century Publishing Corporation. All rights Reserved.


Pan Y.,Capital Medical University | Pan Y.,Beijing Institute for Brain Disorders | Jing J.,Capital Medical University | Jing J.,Beijing Institute for Brain Disorders | And 9 more authors.
Neurology | Year: 2016

Objective: To investigate whether abnormal glucose regulation contributes to a new stroke in patients with a minor ischemic stroke or TIA. Methods: We derived data from the Clopidogrel in High-risk patients with Acute Nondisabling Cerebrovascular Events trial. Patients with a minor stroke or TIA were categorized into 3 groups: patients with diabetes mellitus (DM), impaired fasting glucose (IFG), and normal fasting plasma glucose. The primary outcome was a new stroke (ischemic or hemorrhagic) at 90 days. We assessed the association between glucose regulation status and risk of stroke by multivariable Cox regression models adjusted for potential covariates. Results: Among 5,135 included patients, 1,587 (30.9%), 409 (8.0%), and 3,139 (61.1%) patients were identified as DM, IFG, and normal glucose, respectively. Compared with normal glucose, IFG (11.0% vs 6.9%; adjusted hazard ratio [adj HR] 1.57, 95% confidence interval [CI] 1.13-2.19) and DM (15.8% vs 6.9%; adj HR 2.38, 95% CI 1.97-2.88) were associated with increased risk of stroke at 3 months after a minor stroke or TIA after adjusted for potential covariates. We found a weak J-shaped association between fasting plasma glucose and risk of stroke with a nadir of 4.9 mmol/L. Conclusions: Both IFG and DM were associated with an increased risk of stroke in patients with a minor stroke or TIA. © 2016 American Academy of Neurology.


PubMed | Capital Medical University, Harbin Medical University and Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease
Type: | Journal: Neuroscience bulletin | Year: 2016

Increasing evidence suggests that low to moderate ethanol ingestion protects against the deleterious effects of subsequent ischemia/reperfusion; however, the underlying mechanism has not been elucidated. In the present study, we showed that expression of the neuronal large-conductance, Ca

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