• Jiejie Li, Yilong Wang, David Wang, Jinxi Lin, Anxin Wang, Xingquan Zhao, Liping Liu, Chunxue Wang, Yongjun Wang, and CHANCE Investigators.
• From the Department of Neurology (J.L., Y.W., J.L., A.W., X.Z., L.L., C.W., Y.W.), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (Y.W.), Beijing; Center of Stroke (Y.W.), Beijing Institute for Brain Disorders, China; and the Illinois Neurological Institute Stroke Network (D.W.), Sisters of the Third Order of St. Francis Healthcare System, University of Illinois College of Medicine, Peoria.
• Neurology. 2015 Mar 31; 84 (13): 1330-6.

ObjectiveTo determine the relationship of glycated albumin (GA) and the recurrence of stroke in patients on either dual or single antiplatelet therapy.MethodsThe Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events trial randomized minor ischemic stroke or TIA patients to antiplatelet therapy of clopidogrel plus aspirin or aspirin alone. A subgroup of 3,044 consecutive patients with baseline GA levels from 73 (64%) prespecified clinical sites was analyzed. Patients were categorized into 2 groups based on GA level of 15.5%, the cut point for development of diabetes. The primary outcome was stroke recurrence during 90-day follow-up. Cox proportional hazards models were used to assess the interaction of GA with randomized antiplatelet therapy on their risk of recurrent stroke.ResultsSignificant interaction of GA levels with the 2 antiplatelet therapy groups was found after adjustment for age, sex, and other conventional confounding factors (p = 0.009). The interaction remained consistent after further adjustment for history of diabetes (p = 0.010). In patients with lower GA level, stroke occurred in 5.5% of patients in the clopidogrel-aspirin group, and 12.7% in the aspirin group (adjusted hazard ratio [HR] 0.40; 95% confidence interval [CI] 0.26-0.61; p < 0.001). Furthermore, in patients with elevated GA level, stroke occurred in 9.2% of patients in the clopidogrel-aspirin group, and 11.4% in the aspirin group (adjusted HR 0.79; 95% CI 0.60-1.05; p = 0.103).ConclusionsGA could be a potential biomarker to predict the effects of dual and single antiplatelet therapy in patients with minor stroke or TIA.© 2015 American Academy of Neurology.

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