Hemoglobin Concentration and Clinical Outcomes After Acute Ischemic Stroke or Transient Ischemic Attack
Background 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, stro...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-12-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.121.022547 |
| _version_ | 1797942696477720576 |
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| author | Runhua Zhang Qin Xu Anxin Wang Yong Jiang Xia Meng Maigeng Zhou Yongjun Wang Gaifen Liu |
| author_facet | Runhua Zhang Qin Xu Anxin Wang Yong Jiang Xia Meng Maigeng Zhou Yongjun Wang Gaifen Liu |
| author_sort | Runhua Zhang |
| collection | DOAJ |
| description | Background 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. Methods and Results 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. Conclusions 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. |
| first_indexed | 2024-04-10T20:12:42Z |
| format | Article |
| id | doaj.art-b9cf6dd369584f4386b68976b19bdb69 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-10T20:12:42Z |
| publishDate | 2021-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-b9cf6dd369584f4386b68976b19bdb692023-01-26T10:36:40ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802021-12-01102310.1161/JAHA.121.022547Hemoglobin Concentration and Clinical Outcomes After Acute Ischemic Stroke or Transient Ischemic AttackRunhua Zhang0Qin Xu1Anxin Wang2Yong Jiang3Xia Meng4Maigeng Zhou5Yongjun Wang6Gaifen Liu7National Center for Chronic and Noncommunicable Disease Control and Prevention Chinese Center for Disease Control and Prevention Beijing ChinaBeijing Tiantan Hospital, Capital Medical University Beijing ChinaBeijing Tiantan Hospital, Capital Medical University Beijing ChinaBeijing Tiantan Hospital, Capital Medical University Beijing ChinaBeijing Tiantan Hospital, Capital Medical University Beijing ChinaNational Center for Chronic and Noncommunicable Disease Control and Prevention Chinese Center for Disease Control and Prevention Beijing ChinaBeijing Tiantan Hospital, Capital Medical University Beijing ChinaBeijing Tiantan Hospital, Capital Medical University Beijing ChinaBackground 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. Methods and Results 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. Conclusions 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.https://www.ahajournals.org/doi/10.1161/JAHA.121.022547anemiafunctional outcomehemoglobinmortalityrecurrencestroke |
| spellingShingle | Runhua Zhang Qin Xu Anxin Wang Yong Jiang Xia Meng Maigeng Zhou Yongjun Wang Gaifen Liu Hemoglobin Concentration and Clinical Outcomes After Acute Ischemic Stroke or Transient Ischemic Attack Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease anemia functional outcome hemoglobin mortality recurrence stroke |
| title | Hemoglobin Concentration and Clinical Outcomes After Acute Ischemic Stroke or Transient Ischemic Attack |
| title_full | Hemoglobin Concentration and Clinical Outcomes After Acute Ischemic Stroke or Transient Ischemic Attack |
| title_fullStr | Hemoglobin Concentration and Clinical Outcomes After Acute Ischemic Stroke or Transient Ischemic Attack |
| title_full_unstemmed | Hemoglobin Concentration and Clinical Outcomes After Acute Ischemic Stroke or Transient Ischemic Attack |
| title_short | Hemoglobin Concentration and Clinical Outcomes After Acute Ischemic Stroke or Transient Ischemic Attack |
| title_sort | hemoglobin concentration and clinical outcomes after acute ischemic stroke or transient ischemic attack |
| topic | anemia functional outcome hemoglobin mortality recurrence stroke |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.121.022547 |
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