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Wang G, Jing J, Wang A, Zhang X, Zhao X, Li Z, Wang C, Li H, Liu L, Wang Y, Wang Y. Non-High-Density Lipoprotein Cholesterol Predicts Adverse Outcomes in Acute Ischemic Stroke. Stroke 2021; 52:2035-2042. [PMID: 34000828 DOI: 10.1161/strokeaha.120.030783] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Guangyao Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (G.W., J.J., A.W., X. Zhang, X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang).,China National Clinical Research Center for Neurological Diseases, Beijing, China (G.W., J.J., A.W., X. Zhang, X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang).,Center of Stroke, Beijing Institute for Brain Disorders, China (G.W., J.J., A.W., X. Zhang., X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang).,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (G.W., J.J., A.W., X. Zhang, X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang)
| | - Jing Jing
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (G.W., J.J., A.W., X. Zhang, X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang).,China National Clinical Research Center for Neurological Diseases, Beijing, China (G.W., J.J., A.W., X. Zhang, X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang).,Center of Stroke, Beijing Institute for Brain Disorders, China (G.W., J.J., A.W., X. Zhang., X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang).,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (G.W., J.J., A.W., X. Zhang, X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang)
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (G.W., J.J., A.W., X. Zhang, X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang).,China National Clinical Research Center for Neurological Diseases, Beijing, China (G.W., J.J., A.W., X. Zhang, X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang).,Center of Stroke, Beijing Institute for Brain Disorders, China (G.W., J.J., A.W., X. Zhang., X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang).,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (G.W., J.J., A.W., X. Zhang, X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang)
| | - Xiaoli Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (G.W., J.J., A.W., X. Zhang, X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang).,China National Clinical Research Center for Neurological Diseases, Beijing, China (G.W., J.J., A.W., X. Zhang, X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang).,Center of Stroke, Beijing Institute for Brain Disorders, China (G.W., J.J., A.W., X. Zhang., X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang).,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (G.W., J.J., A.W., X. Zhang, X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang)
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (G.W., J.J., A.W., X. Zhang, X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang).,China National Clinical Research Center for Neurological Diseases, Beijing, China (G.W., J.J., A.W., X. Zhang, X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang).,Center of Stroke, Beijing Institute for Brain Disorders, China (G.W., J.J., A.W., X. Zhang., X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang).,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (G.W., J.J., A.W., X. Zhang, X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang)
| | - Zixiao Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (G.W., J.J., A.W., X. Zhang, X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang).,Center of Stroke, Beijing Institute for Brain Disorders, China (G.W., J.J., A.W., X. Zhang., X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang).,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (G.W., J.J., A.W., X. Zhang, X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang)
| | - Chunjuan Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (G.W., J.J., A.W., X. Zhang, X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang).,China National Clinical Research Center for Neurological Diseases, Beijing, China (G.W., J.J., A.W., X. Zhang, X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang).,Center of Stroke, Beijing Institute for Brain Disorders, China (G.W., J.J., A.W., X. Zhang., X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang).,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (G.W., J.J., A.W., X. Zhang, X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang)
| | - Hao Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (G.W., J.J., A.W., X. Zhang, X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang).,China National Clinical Research Center for Neurological Diseases, Beijing, China (G.W., J.J., A.W., X. Zhang, X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang).,Center of Stroke, Beijing Institute for Brain Disorders, China (G.W., J.J., A.W., X. Zhang., X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang)
| | - Liping Liu
- China National Clinical Research Center for Neurological Diseases, Beijing, China (G.W., J.J., A.W., X. Zhang, X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang).,Center of Stroke, Beijing Institute for Brain Disorders, China (G.W., J.J., A.W., X. Zhang., X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang).,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (G.W., J.J., A.W., X. Zhang, X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang)
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (G.W., J.J., A.W., X. Zhang, X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang).,China National Clinical Research Center for Neurological Diseases, Beijing, China (G.W., J.J., A.W., X. Zhang, X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang).,Center of Stroke, Beijing Institute for Brain Disorders, China (G.W., J.J., A.W., X. Zhang., X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang).,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (G.W., J.J., A.W., X. Zhang, X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang)
| | - Yilong Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (G.W., J.J., A.W., X. Zhang, X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang).,China National Clinical Research Center for Neurological Diseases, Beijing, China (G.W., J.J., A.W., X. Zhang, X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang).,Center of Stroke, Beijing Institute for Brain Disorders, China (G.W., J.J., A.W., X. Zhang., X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang).,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (G.W., J.J., A.W., X. Zhang, X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang)
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De Bacquer D, Ueda P, Reiner Ž, De Sutter J, De Smedt D, Lovic D, Gotcheva N, Fras Z, Pogosova N, Mirrakhimov E, Lehto S, Jernberg T, Kotseva K, Rydén L, Wood D, De Backer G. Prediction of recurrent event in patients with coronary heart disease: the EUROASPIRE Risk Model. Eur J Prev Cardiol 2020; 29:328-339. [PMID: 33623999 DOI: 10.1093/eurjpc/zwaa128] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 11/04/2020] [Accepted: 11/10/2020] [Indexed: 11/13/2022]
Abstract
AIMS Most patients with established atherosclerotic cardiovascular disease (CVD) are at very high risk for developing recurrent events. Since this risk varies a lot between patients there is a need to identify those in whom an even more intensive secondary prevention strategy should be envisaged. Using data from the EUROASPIRE IV and V cohorts of coronary heart disease (CHD) patients from 27 European countries, we aimed at developing and internally and externally validating a risk model predicting recurrent CVD events in patients aged < 75 years. METHODS AND RESULTS Prospective data were available for 12 484 patients after a median follow-up time of 1.7 years. The primary endpoint, a composite of fatal CVD or new hospitalizations for non-fatal myocardial infarction (MI), stroke, heart failure, coronary artery bypass graft, or percutaneous coronary intervention (PCI), occurred in 1424 patients. The model was developed based on data from 8000 randomly selected patients in whom the association between potential risk factors and the incidence of the primary endpoint was investigated. This model was then validated in the remaining 4484 patients. The final multivariate model revealed a higher risk for the primary endpoint with increasing age, a previous hospitalization for stroke, heart failure or PCI, a previous diagnosis of peripheral artery disease, self-reported diabetes and its glycaemic control, higher non-high-density lipoprotein cholesterol, reduced renal function, symptoms of depression and anxiety and living in a higher risk country. The model demonstrated excellent internal validity and proved very adequate in the validation cohort. Regarding external validity, the model demonstrated good discriminative ability in 20 148 MI patients participating in the SWEDEHEART register. Finally, we developed a risk calculator to estimate risks at 1 and 2 years for patients with stable CHD. CONCLUSION In patients with CHD, fatal and non-fatal rates of recurrent CVD events are high. However, there are still opportunities to optimize their management in order to prevent further disease or death. The EUROASPIRE Risk Calculator may be of help to reach this goal.
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Affiliation(s)
- Dirk De Bacquer
- Department of Public Health and Primary Care, Ghent University, C. Heymanslaan 10, 9000 Gent, Belgium
| | - Peter Ueda
- Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.,Department of Internal Medicine, University Hospital Center Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Željko Reiner
- Department of Internal Medicine, University Hospital Center Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Johan De Sutter
- Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium.,Department of Cardiology, AZ Maria Middelares Ghent, Ghent, Belgium
| | - Delphine De Smedt
- Department of Public Health and Primary Care, Ghent University, C. Heymanslaan 10, 9000 Gent, Belgium
| | - Dragan Lovic
- Cardiology Department, School of Medicine, Clinic for Internal Disease Intermedica, Hypertensive Centre, Singidunum University, Nis, Serbia
| | - Nina Gotcheva
- Department of Cardiology, National Heart Hospital, Sofia, Bulgaria
| | - Zlatko Fras
- Department of Vascular Medicine, Division of Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Nana Pogosova
- National Medical Research Centre of Cardiology of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Erkin Mirrakhimov
- Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan.,National Centre of Cardiology and Internal Medicine named after academician Mirrakhimov MM, Bishkek, Kyrgyzstan
| | | | - Tomas Jernberg
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Kornelia Kotseva
- National Heart and Lung Institute, Imperial College London, London, UK.,National University of Ireland, Galway, Ireland
| | - Lars Rydén
- Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - David Wood
- National Heart and Lung Institute, Imperial College London, London, UK.,National University of Ireland, Galway, Ireland
| | - Guy De Backer
- Department of Public Health and Primary Care, Ghent University, C. Heymanslaan 10, 9000 Gent, Belgium
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