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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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 D.,Capital Medical University | Wang D.,China National Clinical Research Center for Neurological Diseases | Wang D.,Beijing Institute for Brain Disorders | Wang D.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease | And 24 more authors.
European Journal of Neurology | Year: 2015

Background and purpose: Since it has remained unclear whether arterial pre-hypertension is a risk factor for cerebrovascular diseases, potential associations between arterial pre-hypertension and intracranial arterial stenosis (ICAS) and extracranial arterial stenosis (ECAS) were assessed. Methods: The population-based Asymptomatic Polyvascular Abnormalities in Community Study was a sub-study of employees and retirees of the coal mining industry in China. Our study examined asymptomatic polyvascular abnormalities in a general population and with an age of 40+ years without history of stroke, transient ischaemic attacks and coronary heart disease. ICAS was diagnosed by transcranial Doppler sonography and was defined by peak flow velocity criteria; ECAS was diagnosed by carotid duplex sonography and was defined by the diameter of the common carotid artery or internal carotid artery. Results: Out of 4422 study participants, 711 (16.1%) subjects showed an asymptomatic ICAS and 292 (6.6%) showed an asymptomatic ECAS. After adjusting for relevant risk factors, higher prevalence of ICAS was significantly associated with higher prevalence of pre-hypertension [odds ratio (OR) 1.55; 95% confidence interval (CI) 1.11, 2.16; P = 0.010] and hypertension (OR 1.80; 95% CI 1.53, 2.11; P < 0.001). Stratified by gender, the association was stronger for men than for women. Asymptomatic ECAS was not significantly associated with the prevalence of pre-hypertension (OR 0.78; 95% CI 0.55, 1.10) or of hypertension (OR 1.06; 95% CI 0.91, 1.24). Conclusions: The results suggest that arterial pre-hypertension in addition to hypertension is associated with a higher prevalence of asymptomatic ICAS, more in men. © 2014 EAN.


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.


Liu L.,Capital Medical University | Liu L.,China National Clinical Research Center for Neurological Diseases | Liu L.,Beijing Institute for Brain Disorders | Liu L.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease | And 39 more authors.
Neurology | Year: 2015

Objective: We aimed to investigate whether the efficacy and safety of clopidogrel plus aspirin vs aspirin alone were consistent between patients with and without intracranial arterial stenosis (ICAS), in the Clopidogrel in High-Risk Patients with Acute Non-disabling Cerebrovascular Events (CHANCE) trial. Methods: We assessed the interaction of the treatment effects of the 2 antiplatelet therapies among patients with and without ICAS, identified by magnetic resonance angiography (MRA) in CHANCE (ClinicalTrials.gov identifier NCT00979589). Results: Overall, 1,089 patients with MRA images available in CHANCE were included in this subanalysis, 608 patients (55.8%) with ICAS and 481 (44.2%) without. Patients with ICAS had higher rates of recurrent stroke (12.5% vs 5.4%; p < 0.0001) at 90 days than those without. But there was no statistically significant treatment by presence of ICAS interaction on either the primary outcome of any stroke (hazard ratio for clopidogrel plus aspirin vs aspirin alone: 0.79 [0.47-1.32] vs 1.12 [0.56-2.25]; interaction p 0.522) or the safety outcome of any bleeding event (interaction p 0.277). Conclusions: The results indicated higher rate of recurrent stroke in minor stroke or high-risk TIA patients with ICAS than in those without. However, there was no significant difference in the response to the 2 antiplatelet therapies between patients with and without ICAS in the CHANCE trial. Classification of evidence: This study provides Class II evidence that for patients with acute minor stroke or TIA with and without ICAS identified by MRA, clopidogrel plus aspirin is not significantly different than aspirin alone in preventing recurrent stroke. © 2015 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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