CO combining power and outcomes in patients with acute ischaemic stroke or transient ischaemic attack.

BACKGROUND AND PURPOSE

The clinical significance of carbon dioxide combining power (COCP) in ischaemic cerebrovascular disease is not well established, and the role of COCP in the prognosis of acute ischaemic stroke (AIS) or transient ischaemic attack (TIA) has not been reported. The objective of the study was to investigate the associations between COCP and clinical outcomes in patients with AIS or TIA.

METHODS

Data were derived from the China National Stroke Registry III. Patients were classified into five groups by quintiles of COCP levels and three groups according to the normal range of COCP (23-29 mmol/L). Multivariable Cox and logistic regressions were adopted to explore the associations of COCP levels with all-cause death and poor functional outcomes (modified Rankin Scale (mRS) 3-6/2-6) at 3 months and 1 year.

RESULTS

Among 9531 patients included in the study, the median (IQR) COCP was 24.9 (23.0-27.0) mmol/L. After adjustment for potential confounders, patients in the first COCP quintile (21.1-23.3 mmol/L) had higher risk of all-cause death and poor functional outcomes (mRS score of 3-6/2-6) (HR or OR with 95% CI 2.37 (1.32 to 4.25), 1.49 (1.20 to 1.83) and 1.21 (1.03 to 1.42), respectively) compared with those in the fourth quintile. Similar results were found for outcomes at 1 year. Furthermore, all associations were also significant when COCP was <23 mmol/L compared with COCP of 23-29 mmol/L.

CONCLUSIONS

Decreased COCP was associated with high risk of all-cause death and poor functional outcomes in patients with AIS or TIA.