From the Department of Neurology (J.Y.C.), Asan Medical Center, Seoul, Korea.
Clinical Research Center (J.S.L.), Asan Medical Center, Seoul, Korea.
Stroke. 2020 Apr;51(4):1309-1312. doi: 10.1161/STROKEAHA.119.028058. Epub 2020 Feb 11.
Background and Purpose- We evaluated whether hemoglobin concentration at admission was associated with stroke recurrence and composite vascular events (stroke, myocardial infarction, and vascular death) in acute ischemic stroke. Methods- We collected data from patients with acute ischemic stroke or transient ischemic attack from a multicenter stroke registry database in Korea. The association of hemoglobin concentration with 1-year stroke recurrence and composite vascular events was evaluated with respect to age, presence of cerebral artery stenosis, stroke severity, and stroke subtype. Results- Hemoglobin levels were inversely associated with stroke recurrence and composite vascular events. One-year rates of stroke recurrence and composite vascular events were significantly higher in patients with anemia or moderate anemia. In multivariable analyses, moderate anemia remained an independent predictor of stroke recurrence (adjusted hazard ratio, 1.43 [95% CI, 1.16-1.75]) and composite vascular events (adjusted hazard ratio, 1.26 [95% CI, 1.07-1.48]). Moderate anemia increased the risk of composite vascular events in patients with mild-to-moderate stroke severity (National Institutes of Health Stroke Scale score <16, =0.01 for interaction). Conclusions- Hemoglobin concentration could be an independent predictor of stroke recurrence and composite vascular events.
背景与目的-我们评估了入院时的血红蛋白浓度与急性缺血性脑卒中患者的卒中复发和复合血管事件（卒中、心肌梗死和血管性死亡）之间的关系。方法-我们从韩国的一个多中心卒中登记数据库中收集了急性缺血性卒中和短暂性脑缺血发作患者的数据。血红蛋白浓度与 1 年卒中复发和复合血管事件的相关性，根据年龄、大脑动脉狭窄、卒中严重程度和卒中亚型进行评估。结果-血红蛋白水平与卒中复发和复合血管事件呈负相关。贫血或中度贫血患者的卒中复发和复合血管事件 1 年发生率显著更高。在多变量分析中，中度贫血仍然是卒中复发（校正后的危险比，1.43[95%可信区间，1.16-1.75]）和复合血管事件（校正后的危险比，1.26[95%可信区间，1.07-1.48]）的独立预测因素。中度贫血增加了轻至中度卒中严重程度（国立卫生研究院卒中量表评分＜16）患者发生复合血管事件的风险（交互作用检验 P=0.01）。结论-血红蛋白浓度可能是卒中复发和复合血管事件的独立预测因素。
