|Title:||Renal dysfunction increases the risk of recurrent stroke in patients with acute ischemic stroke||Authors:||Wang I.-K.
Taiwan Stroke Registry Investigators
|Keywords:||Estimated glomerular filtration rate; Ischemic stroke; Recurrent stroke; Renal function||Issue Date:||2018||Journal Volume:||277||Start page/Pages:||15-20||Source:||Atherosclerosis||Abstract:||
Background and aims: This study investigated risks of short-term (1 and 3 months) and long-term (1-year) recurrent stroke associated with glomerular filtration rate (eGFR) in patients with acute ischemic stroke. Methods: From the Taiwan Stroke Registry data, we identified 45,876 acute ischemic stroke patients from April 2006 to April 2014 and classified them into 4 groups based on the eGFR at admission: ? 90, 60–89, 30–59, and <30 mL/min/1.73 m2 or on dialysis. The risks of 1-month, 3-month and 1-year recurrent stroke related to the eGFR levels were investigated. Results: Both the risks of short-term and long-term recurrent stroke increased as the eGFR levels declined. The 1-month recurrent incidence rates increased steadily from 0.54 to 0.59, 0.84 and 0.89 per 1000 person-days, as the eGFR declined from ?90 to 60–89, 30–59, and <30 mL/min/1.73 m2 or on dialysis, respectively. Compared to patients with eGFR ?90 mL/min/1.73 m2, the adjusted subhazard ratio of 1-month recurrent stroke decreased from 1.69 (95% confidence interval (CI) = 1.24–2.31) for patients with eGFR < 30 mL/min/1.73 m2 or on dialysis to 1.14 (95% CI = 0.91–1.43) for patients with eGFRs of 60–89 mL/min/1.73 m2, considering the competing risk of deaths. Similar patterns were also observed for the adjusted HRs of 3-month and 1-year recurrent stroke, but with reduced hazard values, by the corresponding eGFR levels. Conclusions: There is an independent graded association between an increased risk of recurrent stroke and declining eGFR levels in patients with acute ischemic stroke. ? 2018 Elsevier B.V.
|ISSN:||219150||DOI:||10.1016/j.atherosclerosis.2018.07.033||SDG/Keyword:||antithrombocytic agent; creatinine; hydroxymethylglutaryl coenzyme A reductase inhibitor; tissue plasminogen activator; warfarin; adult; aged; Article; brain ischemia; cerebrovascular accident; creatinine blood level; diabetes mellitus; disease association; estimated glomerular filtration rate; female; human; kidney failure; major clinical study; male; middle aged; priority journal; recurrent disease; renal replacement therapy; risk factor; Taiwan; brain ischemia; cerebrovascular accident; clinical trial; factual database; glomerulus filtration rate; hemodialysis; incidence; kidney; kidney disease; multicenter study; pathophysiology; prognosis; recurrent disease; risk assessment; time factor; very elderly; Aged; Aged, 80 and over; Brain Ischemia; Databases, Factual; Female; Glomerular Filtration Rate; Humans; Incidence; Kidney; Kidney Diseases; Male; Middle Aged; Prognosis; Recurrence; Renal Dialysis; Risk Assessment; Risk Factors; Stroke; Taiwan; Time Factors
|Appears in Collections:||醫學院附設醫院 (臺大醫院)|
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