Hemoglobin Concentration and Clinical Outcomes After Acute Ischemic Stroke or Transient Ischemic Attack.
Hemoglobin Concentration and Clinical Outcomes After Acute Ischemic Stroke or Transient Ischemic Attack.
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急性缺血性中风或短暂性缺血发作后的血红蛋白浓度和临床结果
DOI：
10.1161/jaha.121.022547
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发表时间：
2021-12-07
影响因子：
5.4
通讯作者：
Liu, Gaifen
中科院分区：
文献类型：
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作者：
Zhang, Runhua;Xu, Qin;Wang, Anxin;Jiang, Yong;Meng, Xia;Zhou, Maigeng;Wang, Yongjun;Liu, Gaifen
贫血或低血红蛋白会增加中风的风险。然而，血红蛋白与卒中后结局之间的关系尚不确定。在这项研究中，我们的目的是调查血红蛋白和临床结局之间的关系，包括1年时的死亡率、不良功能结局、卒中复发和复合血管事件。我们纳入了第三次中国国家卒中登记中心诊断为急性缺血性卒中或短暂性脑缺血发作的患者。我们采用考克斯模型分析死亡率、卒中复发和复合血管事件，采用逻辑斯谛模型分析功能不良结局，以研究血红蛋白与临床结局之间的关系。此外，我们使用限制三次样条来评估的非线性关系。本研究包括14159例急性缺血性卒中或短暂性脑缺血发作患者。在调整了潜在的共同创始人之后，贫血和高血红蛋白都与较高的死亡风险相关（风险比[HR]，1.73; 95% CI，1.39-2.15; HR，2.71; 95% CI，1.95-3.76）和功能结局差（比值比[OR]，1.36; 95% CI，1.18-1.57; OR，1.42; 95% CI，1.07-1.87）。高血红蛋白增加了卒中复发（HR，1.37; 95% CI，1.05-1.79）和复合血管事件（HR，1.41; 95% CI，1.08-1.83）的风险，但贫血不增加。血红蛋白与死亡率和不良功能结局之间存在U形关系。血红蛋白异常与全因死亡率、功能结局差、卒中复发和复合血管事件的风险较高相关。需要更多设计良好的临床研究来确认血红蛋白与中风后临床结果之间的关系。
Anemia or low hemoglobin can increase the risk of stroke. However, the association between hemoglobin and outcomes after stroke is uncertain. In this study, we aimed to investigate the association between hemoglobin and clinical outcomes, including mortality, poor functional outcome, stroke recurrence, and composite vascular events at 1 year. We included the patients diagnosed with acute ischemic stroke or transient ischemic attack from the Third China National Stroke Registry. We used the Cox model for mortality, stroke recurrence, and composite vascular events and the logistic model for the poor functional outcome to examine the relationship between hemoglobin and clinical outcomes. In addition, we used the restricted cubic spline to evaluate the nonlinear relationship. This study included 14 159 patients with acute ischemic stroke or transient ischemic attack. After adjusted for potential cofounders, both anemia and high hemoglobin were associated with the higher risk of mortality (hazard ratio [HR], 1.73; 95% CI, 1.39–2.15; HR, 2.71; 95% CI, 1.95–3.76) and poor functional outcome (odds ratio [OR], 1.36; 95% CI, 1.18–1.57; OR, 1.42; 95% CI, 1.07–1.87). High hemoglobin, but not anemia, increased the risk of stroke recurrence (HR, 1.37; 95% CI, 1.05–1.79) and composite vascular events (HR, 1.41; 95% CI, 1.08–1.83). There was a U‐shaped relationship between hemoglobin and mortality and poor functional outcome. Abnormal hemoglobin was associated with a higher risk of all‐cause mortality, poor functional outcome, stroke recurrence, and composite vascular events. More well‐designed clinical studies are needed to confirm the relationship between hemoglobin and clinical outcomes after stroke.