Population-Based Study of Blood Biomarkers in Prediction of Subacute Recurrent Stroke

This scientific commentary refers to ‘Plasma total-tau, neurofilament light chain and amyloid-β levels and risk of dementia: a population-based study’ by de Wolf et al. (https://doi.org/10.1093/brain/awaa054), and ‘Relationship of amyloid-b1–42 in blood and brain amyloid: Ginkgo Evaluation of Memory Study’ by Lopez et al. (https://doi.org/10.1093/braincomms/fcz038), two papers that illustrate these latest developments.

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Population-based study of delays in carotid imaging and surgery and the risk of recurrent stroke

Neurology ◽

10.1212/01.wnl.0000170368.82460.b4 ◽

2005 ◽

Vol 65 (3) ◽

pp. 371-375 ◽

Cited By ~ 187

Author(s):

J. F. Fairhead ◽

Z. Mehta ◽

P. M. Rothwell

Keyword(s):

Recurrent Stroke ◽

Population Based ◽

Population Based Study

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Associations of blood biomarkers with glomerular filtration rate in patients with TIA and stroke: population-based study

Stroke and Vascular Neurology ◽

10.1136/svn-2020-000422 ◽

2020 ◽

pp. svn-2020-000422

Author(s):

Dearbhla M. Kelly ◽

Linxin Li ◽

Annette I Burgess ◽

Deborah L Poole ◽

Julia M Duerden ◽

...

Keyword(s):

Risk Factors ◽

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Chronic Inflammation ◽

Filtration Rate ◽

Population Based ◽

Tumour Necrosis Factor Receptor ◽

Blood Biomarkers ◽

Population Based Study ◽

Fatty Acid Binding

Background and purposeNon-traditional risk factors such as chronic inflammation, oxidative stress and thrombogenic factors are believed to contribute to the excess stroke risk in chronic kidney disease (CKD) by triggering vascular injury and endothelial dysfunction. We aimed to determine how well a panel of biomarkers representative of these factors would correlate with estimated glomerular filtration rate (eGFR) in patients with recent transient ischaemic attack (TIA) or stroke. We also investigated whether eGFR would confound previously reported associations between biomarkers and mortality.MethodsWe studied a panel of 16 blood biomarkers related to inflammation, thrombosis, atherogenesis and cardiac or neuronal cell damage in TIA or ischaemic stroke in a population-based study (Oxford Vascular Study). Biomarker levels were log-transformed and correlated with eGFR, adjusted for age. Cox proportional hazard models were used for survival analysis.ResultsAmong 1297 patients with TIA or stroke, 52.7% (n=684) of patients had CKD (eGFR <60 mL/min/1.73 m2). There was a moderate correlation between log-eGFR and the log-transformed soluble tumour necrosis factor receptor-1 (R2=0.21), attenuating with adjustment for age (R2=0.12). There were moderate-to-strong correlations with markers of cardiac injury, N-terminal pro-brain natriuretic peptide and heart-type fatty acid binding protein (hFABP, R2=0.14 and 0.34, respectively). The strongest correlation after adjustment for age was between hFABP and eGFR (R2=0.20). Adjusting for eGFR did not impact any biomarker associations with mortality.ConclusionsCorrelations between biomarkers related to inflammation and thrombosis with renal dysfunction in the setting of cerebrovascular events were generally modest after adjustment for age, suggesting that putative risk factors such as chronic inflammation or coagulopathy are unlikely to be important stroke mechanisms in patients with CKD.

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Comparison of metabolic phenotypes and BMI as indicators of recurrent stroke in Chinese hospitalized stroke patients: a retrospective study

10.21203/rs.3.rs-551090/v1 ◽

2021 ◽

Author(s):

Xiaolin Huang ◽

Jiaojiao Zhou ◽

Hong Zhang ◽

Pei Gao ◽

Long Wang ◽

...

Keyword(s):

Risk Factors ◽

Recurrent Stroke ◽

Population Based ◽

Metabolic Status ◽

Stroke Patients ◽

Population Based Study ◽

Metabolic Phenotypes ◽

History Of ◽

Integrated Discrimination Improvement ◽

Conventional Risk Factors

Abstract Background Metabolic status and body mass index (BMI) are known as apparent risk factors of recurrent stroke, but which one is more likely related to recurrent stroke remains uncertain. This study aimed to compare the metabolic phenotypes and BMI as indicators of recurrent stroke in Chinese hospitalized stroke patients. Methods In this retrospective population-based study, 856 hospitalized stroke patients from the Third Affiliated Hospital of Soochow University were enrolled. Recurrent stroke was defined as newly-onset stroke patients with a history of previous stroke. Metabolic phenotypes were based on Adult Treatment Panel III criteria. BMI ≥ 25kg/m2 was defined as obesity. Results Among the hospitalized stroke patients, the prevalence of recurrent stroke was 21.9%. Metabolic phenotypes rather than BMI were significantly associated with recurrent stroke. Compared with metabolically healthy patients, metabolically unhealthy ones had 72% (odds ratio [OR] = 1.72, 95% confidence interval [CI] 1.01–2.68) increased recurrent stroke, regardless of BMI and other confounding factors. Whereas, no statistical association between BMI and recurrent stroke were found. Metabolic status improved risk prediction of recurrent stroke when adding to conventional risk factors (net reclassification index 17.6%, P = 0.0047; integrated discrimination improvement 0.7%, P = 0.014), while BMI did not. Conclusions Recurrent stroke was likely associated with poor metabolic status rather than with BMI, suggesting that controlling metabolic abnormalities could be an important method for recurrent stroke prevention.

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Blood Biomarkers and Functional Disability Among Extremely Longevous Individuals: A Population-Based Study

The Journals of Gerontology Series A ◽

10.1093/gerona/glu229 ◽

2014 ◽

Vol 70 (5) ◽

pp. 623-627 ◽

Cited By ~ 8

Author(s):

Zuyun Liu ◽

Yong Wang ◽

Jiapin Huang ◽

Xuefeng Chu ◽

Degui Qian ◽

...

Keyword(s):

Functional Disability ◽

Population Based ◽

Blood Biomarkers ◽

Population Based Study

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Ten-year risks of recurrent stroke, disability, dementia and cost in relation to site of primary intracerebral haemorrhage: population-based study

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2019-322663 ◽

2020 ◽

Vol 91 (6) ◽

pp. 580-585 ◽

Cited By ~ 1

Author(s):

Linxin Li ◽

Ramon Luengo-Fernandez ◽

Susanna M Zuurbier ◽

Nicola C Beddows ◽

Philippa Lavallee ◽

...

Keyword(s):

Quality Of Life ◽

Intracerebral Haemorrhage ◽

Recurrent Stroke ◽

Population Based ◽

Population Based Study ◽

Effective Prevention ◽

Stroke Disability

BackgroundPatients with primary intracerebral haemorrhage (ICH) are at increased long-term risks of recurrent stroke and other comorbidities. However, available estimates come predominantly from hospital-based studies with relatively short follow-up. Moreover, there are also uncertainties about the influence of ICH location on risks of recurrent stroke, disability, dementia and quality of life.MethodsIn a population-based study (Oxford Vascular Study/2002–2018) of patients with a first ICH with follow-up to 10 years, we determined the long-term risks of recurrent stroke, disability, quality of life, dementia and hospital care costs stratified by haematoma location.ResultsOf 255 cases with primary ICH (mean/SD age 75.5/13.1), 109 (42.7%) had lobar ICH, 144 (56.5%) non-lobar ICH and 2 (0.8%) had uncertain location. Annual rates of recurrent ICH were higher after lobar versus non-lobar ICH (lobar=4.0%, 2.7–7.2 vs 1.1%, 0.3–2.8; p=0.02). Moreover, cumulative rate of dementia was also higher for lobar versus non-lobar ICH (n/% lobar=20/36.4% vs 16/20.8%, p=0.047), and there was a higher proportion of disability at 5 years in survivors (15/60.0% vs 9/31.0%, p=0.03). The 10-year quality-adjusted life years (QALYs) were also lower after lobar versus non-lobar ICH (2.9 vs 3.8 for non-lobar, p=0.04). Overall, the mean 10-year censor-adjusted costs were £19 292, with over 80% of costs due to inpatient hospital admission costs, which did not vary by haematoma location (p=0.90).ConclusionCompared with non-lobar ICH, the substantially higher 10-year risks of recurrent stroke, dementia and lower QALYs after lobar ICH highlight the need for more effective prevention for this patient group.

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