臺大醫院-內科部;臺大醫學院;臺大醫學院-內科;Chen, Hung-YuanHung-YuanChenChiu, Yen-LingYen-LingChiuHsu, Shih-PingShih-PingHsuPai, Mei-FenMei-FenPaiYang, Ju-YehJu-YehYangPeng, Yu-SenYu-SenPeng2014-02-142018-07-112014-02-142018-07-112013http://ntur.lib.ntu.edu.tw//handle/246246/259498Background and objectives Fetuin A, a predictor of mortality in dialysis patients, is associated with vascular calcification and atherosclerosis in haemodialysis (HD) patients. Whether it predicts stroke remains unknown. This study aimed to investigate the association between fetuin A and incident stoke in maintenance HD patients. Design, setting, participants and measurements This is a prospective observational study. 238 prevalent HD patients (127 women and 111 men; mean age, 60 +/- 12years) were followed up for the occurrence of stroke for 55months. Baseline circulating fetuin A levels, biochemical data and other markers of inflammation were measured. The major outcome was the occurrence of incident ischaemic or haemorrhagic stroke. Results Thirty one patients had incident strokes; an incidence of 38 center dot 4/1000 patient-years (95% confidence interval (CI) 36 center dot 539 center dot 8/1000 patient-years) on follow-up. Patients in the lowest tertile of fetuin A concentration had highest risk to have incident stroke (P<0 center dot 001, log-rank test). By Cox proportional-hazards regression, patients with higher fetuin A levels experienced lower incidence of stroke, hazard ratio (HR) of 0 center dot 89 (95% CI, 0 center dot 840 center dot 96), while those with higher mean arterial blood pressure had an HR of 1 center dot 19 (95% CI, 1 center dot 071 center dot 34) and those with higher calcium phosphate product (CaxP) had an HR of 1 center dot 39 (95% CI, 1 center dot 11 center dot 73) for having strokes. For patients without previous history of diabetes and cerebrovascular disease, fetuin A deficiency also predicts the occurrence of incident stroke. Conclusions Fetuin A deficiency is associated with a higher risk of incident stroke among prevalent HD patients.99 bytestext/htmlAtherosclerosiscalcium phosphate productfetuin Ahaemodialysisincident stroke[SDGs]SDG3biochemical marker; fetuin A; adult; aged; article; brain hemorrhage; cerebrovascular accident; controlled study; diabetes mellitus; disease association; disease duration; female; follow up; hemodialysis; human; major clinical study; male; mean arterial pressure; medical history; observational study; outcome assessment; priority journal; prospective study; protein blood level; Aged; alpha-2-HS-Glycoprotein; Female; Humans; Incidence; Male; Middle Aged; Proportional Hazards Models; Prospective Studies; Renal Dialysis; Risk Factors; Stroke10.1111/eci.12057http://ntur.lib.ntu.edu.tw/bitstream/246246/259498/1/index.html