Renal Function and Risk Stratification of Patients With Embolic Stroke of Undetermined Source

DOI Web Site 被引用文献1件
  • George Ntaios
    From the Department of Internal Medicine, Larissa University Hospital, School of Medicine, University of Thessaly, Greece (G.N, D.L., K.P., A.V., E.K., V.P.)
  • Gregory Y.H. Lip
    Institute of Cardiovascular Science, University of Birmingham, United Kingdom (G.Y.H.L.)
  • Dimitris Lambrou
    From the Department of Internal Medicine, Larissa University Hospital, School of Medicine, University of Thessaly, Greece (G.N, D.L., K.P., A.V., E.K., V.P.)
  • Patrik Michel
    Stroke Center, Lausanne University Hospital, Switzerland (P.M., K.P., A.E., S.N., G.S., D.S.)
  • Kalliopi Perlepe
    From the Department of Internal Medicine, Larissa University Hospital, School of Medicine, University of Thessaly, Greece (G.N, D.L., K.P., A.V., E.K., V.P.)
  • Ashraf Eskandari
    Stroke Center, Lausanne University Hospital, Switzerland (P.M., K.P., A.E., S.N., G.S., D.S.)
  • Stefania Nannoni
    Stroke Center, Lausanne University Hospital, Switzerland (P.M., K.P., A.E., S.N., G.S., D.S.)
  • Gaia Sirimarco
    Stroke Center, Lausanne University Hospital, Switzerland (P.M., K.P., A.E., S.N., G.S., D.S.)
  • Davide Strambo
    Stroke Center, Lausanne University Hospital, Switzerland (P.M., K.P., A.E., S.N., G.S., D.S.)
  • Konstantinos Vemmos
    Hellenic Cardiovascular Research Society, Athens, Greece (K.V.)
  • Eleni Koroboki
    First Department of Neurology, National and Kapodistrian University of Athens, Greece (E.K.)
  • Efstathios Manios
    Department of Clinical Therapeutics, Medical School of Athens, Alexandra Hospital, Athens, Greece (E.M.)
  • Anastasia Vemmou
    From the Department of Internal Medicine, Larissa University Hospital, School of Medicine, University of Thessaly, Greece (G.N, D.L., K.P., A.V., E.K., V.P.)
  • Ana Rodríguez-Campello
    Stroke Unit, Department of Neurology, Hospital del Mar. Neurovascular Research Group, IMIM-Hospital del Mar (Institut Hospital del Mar d’ Investigacions Mèdiques), Universitat Autònoma de Barcelona, Spain (A.R.-C., E.C.-G., J.R.)
  • Elisa Cuadrado-Godia
    Stroke Unit, Department of Neurology, Hospital del Mar. Neurovascular Research Group, IMIM-Hospital del Mar (Institut Hospital del Mar d’ Investigacions Mèdiques), Universitat Autònoma de Barcelona, Spain (A.R.-C., E.C.-G., J.R.)
  • Jaume Roquer
    Stroke Unit, Department of Neurology, Hospital del Mar. Neurovascular Research Group, IMIM-Hospital del Mar (Institut Hospital del Mar d’ Investigacions Mèdiques), Universitat Autònoma de Barcelona, Spain (A.R.-C., E.C.-G., J.R.)
  • Valentina Arnao
    Stroke Unit, University of Perugia, Italy (V.A., V.C., M.P.)
  • Valeria Caso
    Stroke Unit, University of Perugia, Italy (V.A., V.C., M.P.)
  • Maurizio Paciaroni
    Stroke Unit, University of Perugia, Italy (V.A., V.C., M.P.)
  • Exuperio Diez-Tejedor
    Department of Neurology and Stroke Center, La Paz University Hospital - Autónoma University of Madrid, IdiPAZ Health Research Institute, Spain (E.D.-T., B.F., J.R.P.)
  • Blanca Fuentes
    Department of Neurology and Stroke Center, La Paz University Hospital - Autónoma University of Madrid, IdiPAZ Health Research Institute, Spain (E.D.-T., B.F., J.R.P.)
  • Jorge Rodríguez Pardo
    Department of Neurology and Stroke Center, La Paz University Hospital - Autónoma University of Madrid, IdiPAZ Health Research Institute, Spain (E.D.-T., B.F., J.R.P.)
  • Antonio Arauz
    Stroke Clinic, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, Mexico (A.A.)
  • Sebastian F. Ameriso
    Department of Neurology, Institute for Neurological Research, FLENI, Buenos Aires, Argentina (S.F.A., L.P., M.G.-S.)
  • Lucía Pertierra
    Department of Neurology, Institute for Neurological Research, FLENI, Buenos Aires, Argentina (S.F.A., L.P., M.G.-S.)
  • Maia Gómez-Schneider
    Department of Neurology, Institute for Neurological Research, FLENI, Buenos Aires, Argentina (S.F.A., L.P., M.G.-S.)
  • Maximiliano A. Hawkes
    Department of Neurology, Division of Critical Care Neurology, Mayo Clinic, Rochester, Minnesota (M.A.H.)
  • Fabio Bandini
  • Beatriz Chavarria Cano
    Department of Neurology, San Paolo Hospital, Savona, Italy (B.C.C., A.M.I.M., A.G.P., A.G.-N.)
  • Ana Maria Iglesias Mohedano
    Department of Neurology, San Paolo Hospital, Savona, Italy (B.C.C., A.M.I.M., A.G.P., A.G.-N.)
  • Andrés García Pastor
    Department of Neurology, San Paolo Hospital, Savona, Italy (B.C.C., A.M.I.M., A.G.P., A.G.-N.)
  • Antonio Gil-Núñez
    Department of Neurology, San Paolo Hospital, Savona, Italy (B.C.C., A.M.I.M., A.G.P., A.G.-N.)
  • Jukka Putaala
    Department of Neurology, Helsinki University Central Hospital and University of Helsinki, Finland (J.P., T.T.)
  • Turgut Tatlisumak
    Department of Neurology, Helsinki University Central Hospital and University of Helsinki, Finland (J.P., T.T.)
  • Miguel A. Barboza
    Neurosciences Department, Hospital Dr. Rafael A. Calderón Guardia, CCSS, University of Costa Rica (M.A.B.)
  • Efstathia Karagkiozi
    From the Department of Internal Medicine, Larissa University Hospital, School of Medicine, University of Thessaly, Greece (G.N, D.L., K.P., A.V., E.K., V.P.)
  • Konstantinos Makaritsis
  • Vasileios Papavasileiou
    From the Department of Internal Medicine, Larissa University Hospital, School of Medicine, University of Thessaly, Greece (G.N, D.L., K.P., A.V., E.K., V.P.)

抄録

<jats:sec> <jats:title>Background and Purpose—</jats:title> <jats:p>We aimed to assess if renal function can aid in risk stratification for ischemic stroke or transient ischemic attack (TIA) recurrence and death in patients with embolic stroke of undetermined source (ESUS).</jats:p> </jats:sec> <jats:sec> <jats:title>Methods—</jats:title> <jats:p>We pooled 12 ESUS datasets from Europe and America. Renal function was evaluated using the estimated glomerular filtration rate (eGFR) and analyzed in continuous, binary, and categorical way. Cox-regression analyses assessed if renal function was independently associated with the risk for ischemic stroke/TIA recurrence and death. The Kaplan-Meier product limit method estimated the cumulative probability of ischemic stroke/TIA recurrence and death.</jats:p> </jats:sec> <jats:sec> <jats:title>Results—</jats:title> <jats:p> In 1530 patients with ESUS followed for 3260 patient-years, there were 237 recurrences (15.9%) and 201 deaths (13.4%), corresponding to 7.3 ischemic stroke/TIA recurrences and 5.6 deaths per 100 patient-years, respectively. Renal function was not associated with the risk for ischemic stroke/TIA recurrence when forced into the final multivariate model, regardless if it was analyzed as continuous (hazard ratio, 1.00; 95% CI, 0.99–1.00 for every 1 mL/min), binary (hazard ratio, 1.27; 95% CI, 0.87–1.73) or categorical covariate (likelihood-ratio test 2.59, <jats:italic>P</jats:italic> =0.63 for stroke recurrence). The probability of ischemic stroke/TIA recurrence across stages of renal function was 11.9% for eGFR ≥90, 16.6% for eGFR 60–89, 21.7% for eGFR 45–59, 19.2% for eGFR 30–44, and 24.9% for eGFR <30 (likelihood-ratio test 2.59, <jats:italic>P</jats:italic> =0.63). The results were similar for the outcome of death. </jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions—</jats:title> <jats:p>The present study is the largest pooled individual patient-level ESUS dataset, and does not provide evidence that renal function can be used to stratify the risk of ischemic stroke/TIA recurrence or death in patients with ESUS.</jats:p> </jats:sec>

収録刊行物

  • Stroke

    Stroke 49 (12), 2904-2909, 2018-12

    Ovid Technologies (Wolters Kluwer Health)

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