Low estimated glomerular filtration rate is associated with poor outcomes in patients who suffered a large artery atherosclerosis stroke

Shin Joe Yeh, Jiann Shing Jeng, Sung Chun Tang, Chung Hsiang Liu, Shih Pin Hsu, Chih Hung Chen, Li-Ming Lien, Huey Juan Lin, Chiu Mei Chen, Ruey Tay Lin, Siu Pak Lee, Ching Huang Lin, Chung Hsin Yeh, Yu Sun, Ming Hui Sun, Jiu Haw Yin, Che Chen Lin, Chi Pang Wen, Li Kai Tsai, Fung Chang Sung & 1 others Chung Y. Hsu

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objectives: The relationship between low estimated glomerular filtration rate (eGFR) and the outcome of ischemic stroke remains controversial, despite the close association between kidney dysfunction and atherosclerosis. Methods: This study conducted subgroup analysis using data from the prospective Taiwan Stroke Registry to investigate the relationship between eGFR at the time of admission and 6-month functional outcomes in patients with the large artery atherosclerotic (LAA) subtype of acute ischemic stroke. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS), and outcomes were defined as modified Rankin Scale and mortality status at 6 months post stroke. Results: Of the 8052 patients with the LAA subtype of acute ischemic stroke in this study, 3312 (41.1%) had eGFR 2. The adjusted odds ratios of worse functional outcomes following a stroke were 1.10 (95% confidence interval [CI], 0.95-1.28), 1.60 (95% CI, 1.22-2.11) and 1.60 (95% CI, 1.10-2.33) in patients with eGFR 30-59, 15-29, and 2, respectively. Increased risk of mortality was closely and independently related to high NIHSS scores and low eGFR levels. Stroke severity and eGFR were also synergistically related to 6-month mortality, with an adjusted hazard ratio of 21.19 (95% CI, 9.69-46.35) in patients with NIHSS >15 and eGFR 2, compared with those with NIHSS 0-5 and eGFR 60-119mL/min/1.73m2. Conclusions: Low eGFR was significantly and independently associated with 6-month functional outcomes and mortality in patients with the LAA subtype of acute ischemic stroke. The deleterious relationship between low eGFR levels and mortality following stroke was exacerbated by its synergistic association with stroke severity.

Original languageEnglish
Pages (from-to)328-334
Number of pages7
JournalAtherosclerosis
Volume239
Issue number2
DOIs
Publication statusPublished - Apr 1 2015
Externally publishedYes

Fingerprint

Glomerular Filtration Rate
Atherosclerosis
Arteries
Stroke
National Institutes of Health (U.S.)
Mortality
Confidence Intervals
Taiwan
Registries

Keywords

  • Atherosclerosis
  • Brain infarction
  • Glomerular filtration rate

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Low estimated glomerular filtration rate is associated with poor outcomes in patients who suffered a large artery atherosclerosis stroke. / Yeh, Shin Joe; Jeng, Jiann Shing; Tang, Sung Chun; Liu, Chung Hsiang; Hsu, Shih Pin; Chen, Chih Hung; Lien, Li-Ming; Lin, Huey Juan; Chen, Chiu Mei; Lin, Ruey Tay; Lee, Siu Pak; Lin, Ching Huang; Yeh, Chung Hsin; Sun, Yu; Sun, Ming Hui; Yin, Jiu Haw; Lin, Che Chen; Wen, Chi Pang; Tsai, Li Kai; Sung, Fung Chang; Hsu, Chung Y.

In: Atherosclerosis, Vol. 239, No. 2, 01.04.2015, p. 328-334.

Research output: Contribution to journalArticle

Yeh, SJ, Jeng, JS, Tang, SC, Liu, CH, Hsu, SP, Chen, CH, Lien, L-M, Lin, HJ, Chen, CM, Lin, RT, Lee, SP, Lin, CH, Yeh, CH, Sun, Y, Sun, MH, Yin, JH, Lin, CC, Wen, CP, Tsai, LK, Sung, FC & Hsu, CY 2015, 'Low estimated glomerular filtration rate is associated with poor outcomes in patients who suffered a large artery atherosclerosis stroke', Atherosclerosis, vol. 239, no. 2, pp. 328-334. https://doi.org/10.1016/j.atherosclerosis.2015.01.038
Yeh, Shin Joe ; Jeng, Jiann Shing ; Tang, Sung Chun ; Liu, Chung Hsiang ; Hsu, Shih Pin ; Chen, Chih Hung ; Lien, Li-Ming ; Lin, Huey Juan ; Chen, Chiu Mei ; Lin, Ruey Tay ; Lee, Siu Pak ; Lin, Ching Huang ; Yeh, Chung Hsin ; Sun, Yu ; Sun, Ming Hui ; Yin, Jiu Haw ; Lin, Che Chen ; Wen, Chi Pang ; Tsai, Li Kai ; Sung, Fung Chang ; Hsu, Chung Y. / Low estimated glomerular filtration rate is associated with poor outcomes in patients who suffered a large artery atherosclerosis stroke. In: Atherosclerosis. 2015 ; Vol. 239, No. 2. pp. 328-334.
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abstract = "Objectives: The relationship between low estimated glomerular filtration rate (eGFR) and the outcome of ischemic stroke remains controversial, despite the close association between kidney dysfunction and atherosclerosis. Methods: This study conducted subgroup analysis using data from the prospective Taiwan Stroke Registry to investigate the relationship between eGFR at the time of admission and 6-month functional outcomes in patients with the large artery atherosclerotic (LAA) subtype of acute ischemic stroke. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS), and outcomes were defined as modified Rankin Scale and mortality status at 6 months post stroke. Results: Of the 8052 patients with the LAA subtype of acute ischemic stroke in this study, 3312 (41.1{\%}) had eGFR 2. The adjusted odds ratios of worse functional outcomes following a stroke were 1.10 (95{\%} confidence interval [CI], 0.95-1.28), 1.60 (95{\%} CI, 1.22-2.11) and 1.60 (95{\%} CI, 1.10-2.33) in patients with eGFR 30-59, 15-29, and 2, respectively. Increased risk of mortality was closely and independently related to high NIHSS scores and low eGFR levels. Stroke severity and eGFR were also synergistically related to 6-month mortality, with an adjusted hazard ratio of 21.19 (95{\%} CI, 9.69-46.35) in patients with NIHSS >15 and eGFR 2, compared with those with NIHSS 0-5 and eGFR 60-119mL/min/1.73m2. Conclusions: Low eGFR was significantly and independently associated with 6-month functional outcomes and mortality in patients with the LAA subtype of acute ischemic stroke. The deleterious relationship between low eGFR levels and mortality following stroke was exacerbated by its synergistic association with stroke severity.",
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AU - Yeh, Shin Joe

AU - Jeng, Jiann Shing

AU - Tang, Sung Chun

AU - Liu, Chung Hsiang

AU - Hsu, Shih Pin

AU - Chen, Chih Hung

AU - Lien, Li-Ming

AU - Lin, Huey Juan

AU - Chen, Chiu Mei

AU - Lin, Ruey Tay

AU - Lee, Siu Pak

AU - Lin, Ching Huang

AU - Yeh, Chung Hsin

AU - Sun, Yu

AU - Sun, Ming Hui

AU - Yin, Jiu Haw

AU - Lin, Che Chen

AU - Wen, Chi Pang

AU - Tsai, Li Kai

AU - Sung, Fung Chang

AU - Hsu, Chung Y.

PY - 2015/4/1

Y1 - 2015/4/1

N2 - Objectives: The relationship between low estimated glomerular filtration rate (eGFR) and the outcome of ischemic stroke remains controversial, despite the close association between kidney dysfunction and atherosclerosis. Methods: This study conducted subgroup analysis using data from the prospective Taiwan Stroke Registry to investigate the relationship between eGFR at the time of admission and 6-month functional outcomes in patients with the large artery atherosclerotic (LAA) subtype of acute ischemic stroke. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS), and outcomes were defined as modified Rankin Scale and mortality status at 6 months post stroke. Results: Of the 8052 patients with the LAA subtype of acute ischemic stroke in this study, 3312 (41.1%) had eGFR 2. The adjusted odds ratios of worse functional outcomes following a stroke were 1.10 (95% confidence interval [CI], 0.95-1.28), 1.60 (95% CI, 1.22-2.11) and 1.60 (95% CI, 1.10-2.33) in patients with eGFR 30-59, 15-29, and 2, respectively. Increased risk of mortality was closely and independently related to high NIHSS scores and low eGFR levels. Stroke severity and eGFR were also synergistically related to 6-month mortality, with an adjusted hazard ratio of 21.19 (95% CI, 9.69-46.35) in patients with NIHSS >15 and eGFR 2, compared with those with NIHSS 0-5 and eGFR 60-119mL/min/1.73m2. Conclusions: Low eGFR was significantly and independently associated with 6-month functional outcomes and mortality in patients with the LAA subtype of acute ischemic stroke. The deleterious relationship between low eGFR levels and mortality following stroke was exacerbated by its synergistic association with stroke severity.

AB - Objectives: The relationship between low estimated glomerular filtration rate (eGFR) and the outcome of ischemic stroke remains controversial, despite the close association between kidney dysfunction and atherosclerosis. Methods: This study conducted subgroup analysis using data from the prospective Taiwan Stroke Registry to investigate the relationship between eGFR at the time of admission and 6-month functional outcomes in patients with the large artery atherosclerotic (LAA) subtype of acute ischemic stroke. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS), and outcomes were defined as modified Rankin Scale and mortality status at 6 months post stroke. Results: Of the 8052 patients with the LAA subtype of acute ischemic stroke in this study, 3312 (41.1%) had eGFR 2. The adjusted odds ratios of worse functional outcomes following a stroke were 1.10 (95% confidence interval [CI], 0.95-1.28), 1.60 (95% CI, 1.22-2.11) and 1.60 (95% CI, 1.10-2.33) in patients with eGFR 30-59, 15-29, and 2, respectively. Increased risk of mortality was closely and independently related to high NIHSS scores and low eGFR levels. Stroke severity and eGFR were also synergistically related to 6-month mortality, with an adjusted hazard ratio of 21.19 (95% CI, 9.69-46.35) in patients with NIHSS >15 and eGFR 2, compared with those with NIHSS 0-5 and eGFR 60-119mL/min/1.73m2. Conclusions: Low eGFR was significantly and independently associated with 6-month functional outcomes and mortality in patients with the LAA subtype of acute ischemic stroke. The deleterious relationship between low eGFR levels and mortality following stroke was exacerbated by its synergistic association with stroke severity.

KW - Atherosclerosis

KW - Brain infarction

KW - Glomerular filtration rate

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