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Dogan L, Seyyar SA, Mercanli M, Tokuc EO. Association of Retinal Vein Occlusion With Serum Osmolality and Hydration Status. Ophthalmic Surg Lasers Imaging Retina 2024; 55:130-135. [PMID: 38319057 DOI: 10.3928/23258160-20240122-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
BACKGROUND AND OBJECTIVE The aim of this study was to evaluate serum osmolality and hydration status in patients with retinal vein occlusion (RVO). PATIENTS AND METHODS This cross-sectional study consisted of 79 patients with RVO and 81 age- and sex-matched peers without ocular disease. Data were collected from patient records and included a comprehensive ophthalmological examination, laboratory data of fasting blood test results, and internal medicine outpatient examination. Complete blood count and levels of fasting glucose, sodium, blood urea nitrogen (BUN), creatinine, triglyceride, low-density lipoprotein, high-density lipoprotein, HbA1c, and serum osmolality were evaluated. BUN/creatinine ratios were calculated. RESULTS Mean serum sodium and serum osmolality levels were 142.53 ± 2.13 and 139.74 ± 2.16 mEq/L and 286.58 ± 4.40 and 280.57 ± 4.39 mOsmol/kg H2O in the RVO and control groups, respectively. Serum osmolality and serum sodium levels, and BUN/creatinine ratio were significantly higher in the RVO group than in controls (P < 0.05 for all). CONCLUSIONS We found that serum osmolality, sodium levels, and the BUN/creatinine ratio increased significantly in the RVO group. The results suggest dehydration status may affect the genesis of vessel occlusion in RVO. [Ophthalmic Surg Lasers Imaging Retina 2024;55:130-135.].
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Liu Y, Zhao J, Li F, Sun H, Sun Y, Sun H, Yang F, Zhao Y, Liang Z, Tang Y. Predictive value of hemoglobin level on early neurological outcomes in acute ischemic stroke. Neurol Res 2022; 44:684-691. [PMID: 35130819 DOI: 10.1080/01616412.2022.2035621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Few studies have examined the association between hemoglobin (Hb) levels and early neurological changes following acute ischemic stroke (AIS). The present research investigated whether higher or lower Hb level on admission was associated with early neurological deterioration (END) in AIS patients. Furthermore, we evaluated the predictive effect of Hb concentration on stable or improving outcome. METHODS In this prospective cohort study, a total of 1330 patients admitted within 24 hours after AIS onset were finally involved in the analysis. We classified participants into four groups according to baseline Hb levels: ≤120, 121-140, 141-160, and >160 g/L. The risk of END was accessed by means of logistic regression analysis, and tendency of improvement and stability by multinomial logit analysis. We further evaluated the pattern and magnitude of association of Hb as a continuous variable and END by multivariate logistic regression analysis of restricted cubic spline. RESULTS Compared with the reference group, hemoglobin >160 g/L was associated with END (OR, 95%CI; 2.149, 1.314-3.512) and severe END (OR, 95% CI as 2.317, 1.351-3.976 and 2.810,1.589-4.968, respectively). Comparatively, higher Hb level also independently predicted improving (OR, 95% CI; 0.322, 0.170-0.609) and stable (OR, 95% CI; 0.371, 0.205-0.673) outcome. Similar results were found when restricted to anterior circulation ischemic stroke after adjustment of variables including large vessel disease. CONCLUSIONS We concluded that patients with higher baseline Hb level are at significantly higher risk for END, and less likely to reach stable or improving status at the early stage of stroke.
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Affiliation(s)
- Yue Liu
- Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Jingbo Zhao
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Fang Li
- Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Hongwei Sun
- Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Yanyan Sun
- Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Hongwei Sun
- Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Fan Yang
- Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Yu Zhao
- Department of Laboratory Diagnosis, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Zijun Liang
- Department of Health Insurance Management, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Ying Tang
- Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
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Donis N, Jiang Z, D'Emal C, Dulgheru R, Giera M, Blomberg N, Delvenne P, Nchimi A, Lancellotti P, Oury C. Regular Dietary Intake of Palmitate Causes Vascular and Valvular Calcification in a Rabbit Model. Front Cardiovasc Med 2021; 8:692184. [PMID: 34250045 PMCID: PMC8261064 DOI: 10.3389/fcvm.2021.692184] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 05/24/2021] [Indexed: 01/23/2023] Open
Abstract
Aims: Palmitic acid (PA) and oleic acid (OA) are two main dietary fatty acids. Dietary intake of PA has been associated with cardiovascular disease risk, and the effect of OA remains uncertain. Our study aimed to assess the effect of a short-term intake of lard, as source of PA and OA, on aorta and aortic valve. Methods and Results: Rabbits were fed with two lard-enriched diets, containing either elevated levels of PA or of both PA and OA as compared to chow diet. After 16 weeks of each diet, calcification was observed in the aortic intima and in the aortic valve. The extent of calcification did not differ between the two diets. In contrast, rabbits fed chow diet did not develop any calcification. In blood, PA enrichment resulted in decreased lymphocyte and monocyte counts and increased levels of hemoglobin and haematocrit. Levels of the calcification inhibitor fetuin-A were also diminished, whereas creatinine levels were raised. Of note, none of the diets changed cholesterol levels in LDL or HDL. Comprehensive quantitative lipidomics analysis identified diet-related changes in plasma lipids. Dietary PA enrichment led to a drop of polyunsaturated fatty acids (PUFA), in particular of linoleic acid in cholesteryl esters, triglycerides and diacylglycerols (DAG). Ratios of PA to 18-carbon PUFA in DAG were positively correlated with the extent of aortic valve calcification, and inversely with monocyte counts. PA content in blood correlated with aorta calcification. Conclusions: Regular dietary PA intake induces vascular and valvular calcification independently of traditional risk factors. Our findings raise awareness about PA-rich food consumption and its potential deleterious effect on cardiovascular health.
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Affiliation(s)
- Nathalie Donis
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, CHU Sart Tilman, University of Liège, Liège, Belgium
| | - Zheshen Jiang
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, CHU Sart Tilman, University of Liège, Liège, Belgium
| | - Céline D'Emal
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, CHU Sart Tilman, University of Liège, Liège, Belgium
| | - Raluca Dulgheru
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, CHU Sart Tilman, University of Liège, Liège, Belgium
| | - Martin Giera
- Center for Proteomics and Metabolomics, Leiden University Medical Center, Leiden, Netherlands
| | - Niek Blomberg
- Center for Proteomics and Metabolomics, Leiden University Medical Center, Leiden, Netherlands
| | - Philippe Delvenne
- Department of Pathology, Centre Hospitalier Universitaire (CHU) University Hospital, Liège University, Liège, Belgium.,Laboratory of Experimental Pathology, Groupe Interdisciplinaire de Géno-protéomique Appliquée (GIGA) Institute, Liege University, Liège, Belgium
| | - Alain Nchimi
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, CHU Sart Tilman, University of Liège, Liège, Belgium
| | - Patrizio Lancellotti
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, CHU Sart Tilman, University of Liège, Liège, Belgium.,Gruppo Villa Maria Care and Research, Maria Cecilia Hospital, Cotignola, Italy.,Anthea Hospital, Bari, Italy
| | - Cécile Oury
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, CHU Sart Tilman, University of Liège, Liège, Belgium
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Huang J, Ma J, Guo Y, Wang Y, Zhang Q, Zhong J, Jiang W, Li Y, Xu L. [Peripheral blood albumin level in significantly correlated with the severity of atherosclerosis in hypertensive patients]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2020; 40:240-245. [PMID: 32376544 DOI: 10.12122/j.issn.1673-4254.2020.02.16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate the relationship between peripheral blood albumin (Hb) level and the severity of arteriosclerosis in hypertensive patients. METHODS This retrospective analysis was conducted among 419 randomly selected patients with hypertension. The pulse wave velocity (ba-PWV) of the bilateral limbs was measured using an arteriosclerosis tester. According to the ba-PWV value (the higher value of the two sides), the hypertensive patients were divided into 4 groups, namely normal arterial group [S0 group, ba-PWV < 1400 cm/s; 49 cases (11.7%)], mild arteriosclerosis group [S1 group, ba-PWV of 1400-1800 cm/s; 190 cases (45.3%)], moderate arteriosclerosis group [S2 group, ba-PWV of 1800-2000 cm/s); 69 cases (16.5%)], and severe arteriosclerosis group [S3 group, ba-PWV > 2 000 cm/s; 111 cases (26.5 %)]. The clinical data of the patients were collected and multivariate logistic regression was used to analyze the risk factors of arteriosclerosis. RESULTS The patients' age, obesity, albumin, alanine aminotransferase (ALT), total bile acid, adenosine deaminase, urea nitrogen, serum creatinine, cystatin C, low-density lipoprotein, red blood cells, hemoglobin (Hb), fibrinogen, and FT3 all differed significantly between S0 group and the 3 arteriosclerosis groups (P < 0.05). Multivariate logistic regression analysis revealed that in hypertensive patients, age was an independent risk factor for severe arteriosclerosis (OR=1.094, 95% CI: 1.052-1.137, P < 0.05) and moderate arteriosclerosis (OR= 1.081, 95% CI: 1.039-1.125, P < 0.05); Hb was an independent risk factor for new-onset severe arteriosclerosis (OR= 1.025, 95% CI: 1.003-1.045, P < 0.05) and moderate arteriosclerosis (OR=1.035, 95% CI: 1.008-1.056, P < 0.05), and an increase of Hb levels by 1 standard deviation was associated with a doubled risk in hypertensive patients. CONCLUSIONS Peripheral Hb level is significantly correlated with the severity of arteriosclerosis and may serve as a new predictor for arteriosclerosis in hypertensive patients.
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Affiliation(s)
- Jianyu Huang
- Guangdong Pharmaceutical University, Guangzhou 510006, China.,General Hospital of Southern Theatre Command of PLA, Guangzhou 510010, China
| | - Jun Ma
- General Hospital of Southern Theatre Command of PLA, Guangzhou 510010, China
| | - Yan Guo
- General Hospital of Southern Theatre Command of PLA, Guangzhou 510010, China
| | - Yao Wang
- Jiangxi Province Hospital of Integrated Chinese and Western Medicine, Nanchang, 330003, China
| | - Qunhui Zhang
- General Hospital of Southern Theatre Command of PLA, Guangzhou 510010, China
| | - Junda Zhong
- General Hospital of Southern Theatre Command of PLA, Guangzhou 510010, China
| | - Wencai Jiang
- Guangdong Pharmaceutical University, Guangzhou 510006, China.,General Hospital of Southern Theatre Command of PLA, Guangzhou 510010, China
| | - Yanzhuo Li
- General Hospital of Southern Theatre Command of PLA, Guangzhou 510010, China
| | - Lin Xu
- Guangdong Pharmaceutical University, Guangzhou 510006, China.,General Hospital of Southern Theatre Command of PLA, Guangzhou 510010, China
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Guo D, Zhang Y. Response to letter of "hemoglobin level as a predictor of clinical outcome in patients with ischemic stroke" by Tomoyuki Kawada. J Neurol Sci 2019; 399:207-208. [PMID: 30851658 DOI: 10.1016/j.jns.2019.02.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 02/25/2019] [Indexed: 10/27/2022]
Affiliation(s)
- Daoxia Guo
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Yonghong Zhang
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China.
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Guo D, Zhu Z, Zhong C, Peng H, Xu T, Wang A, Peng Y, Xu T, Chen CS, Li Y, Ju Z, Chen J, Zhang Y, He J. Hemoglobin level and three-month clinical outcomes among ischemic stroke patients with elevated systolic blood pressure. J Neurol Sci 2018; 396:256-261. [PMID: 30530284 DOI: 10.1016/j.jns.2018.11.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 11/19/2018] [Accepted: 11/26/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Previous studies have reported that extreme low and high hemoglobin levels are positively associated with the risk of ischemic stroke. However, there are few reports on the relationship between hemoglobin at acute phase and clinical outcomes after ischemic stroke and the results of their association to date are inconsistent. We aimed to investigate the association between them in a large prospective cohort of ischemic stroke patients. METHODS Baseline hemoglobin levels were measured in 3881 patients with acute ischemic stroke. The primary outcome was defined as composite outcome of major disability and death (modified Rankin Scale score ≥ 3) at 3 months after stroke onset. Secondary outcomes were separately those of major disability and death. RESULTS Compared with the lowest quartile of hemoglobin, the multivariate adjusted odds ratios (95% confidence intervals) associated with the highest quartile were 1.38 (1.03-1.86), 1.49 (1.11-1.99), 0.79 (0.41-1.52) for primary outcome, major disability and death, respectively. Multiple-adjusted spline regression model showed linear associations of hemoglobin levels with primary outcome (P for linearity =0.037) and major disability (P for linearity =0.004). Subgroup analyses further confirmed the positive association between high hemoglobin and poor prognosis of ischemic stroke. CONCLUSIONS Elevated hemoglobin levels in the acute phase were associated with poor prognosis at 3 months after ischemic stroke. Further prospective studies from other samples of ischemic stroke patients are needed to validate our findings.
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Affiliation(s)
- Daoxia Guo
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Zhengbao Zhu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States
| | - Chongke Zhong
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States
| | - Hao Peng
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Tian Xu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China; Department of Neurology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Aili Wang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Yanbo Peng
- Department of Neurology, Affiliated Hospital of Hebei United University, Hebei, China
| | - Tan Xu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Chung-Shiuan Chen
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States
| | - Yongqiu Li
- Department of Neurology, Tangshan Worker's Hospital, Hebei, China
| | - Zhong Ju
- Department of Neurology, Kerqin District First People's Hospital of Tongliao City, Inner Mongolia, China
| | - Jing Chen
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States; Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - Yonghong Zhang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China.
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States; Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA
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Hashem SS, Helmy SM, El-Fayomy NM, Oraby MI, Menshawy M, Dawood NA, Hashem HS. Predictors of stroke outcome: the role of hemorheology, natural anticoagulants, and serum albumin. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2018; 54:18. [PMID: 30046235 PMCID: PMC6028876 DOI: 10.1186/s41983-018-0019-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 06/14/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The early hours after an acute stroke are crucial; early accurate prediction of outcome in stroke patients can help health system providers and families to choose appropriate lines of management and plan for the future. The aim of this work is to assess the role of hemorheological parameters (such as blood viscosity, hematocrit, platelet aggregation, and leukocyte count), protein C, protein S, antithrombin III, and serum albumin as predictors of stroke outcome. METHODS Thirty subjects, 20 patients with acute ischemic stroke within 24 h from the onset and 10 normal subjects, were included in this case control study. Clinical, functional, and radiological evaluation was done for the patients, and all patients and control were subjected to routine laboratory tests and assessment of blood viscosity, hematocrit level, platelet aggregation, protein C, protein S, and antithrombin III. RESULTS Platelet aggregation was significantly higher and serum albumin was significantly lower in stroke patients compared to control (p value = 0.000 and 0.039) respectively. On comparing between patient with good and poor outcome, good outcome was associated with increased serum albumin level at admission (p value = 0.03) respectively. A significant negative correlation was found between total leukocyte count, hematocrit value, and stroke outcome (p value = 0.015 and 0.013) respectively. Only albumin was found to be a significant predictor for outcome by linear regression analysis. CONCLUSION Serum albumin, hematocrit level, and total leukocyte count at the time of presentation of ischemic stroke are useful markers for stroke outcome.
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Affiliation(s)
| | | | | | | | | | | | - Heba S. Hashem
- Neurology Department, National Institute of Research, Giza, Egypt
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Sico JJ, Myers LJ, Fenton BJ, Concato J, Williams LS, Bravata DM. Association between admission haematocrit and mortality among men with acute ischaemic stroke. Stroke Vasc Neurol 2018; 3:160-168. [PMID: 30294472 PMCID: PMC6169611 DOI: 10.1136/svn-2018-000149] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 02/20/2018] [Indexed: 12/04/2022] Open
Abstract
Objective Anaemia is associated with higher mortality among patients with non-stroke cardiovascular conditions; less is known regarding the relationship between anaemia and mortality among patients with acute ischaemic stroke. Methods Medical records were abstracted for n=3965 veterans from 131 Veterans Health Administration facilities who were admitted with ischaemic stroke in fiscal year 2007. Haematocrit values within 24 hours of admission were classified as ≤27%, 28%–32%, 33%–37%, 38%–42%, 43%–47% or ≥48%. Multivariate logistic regression was used to examine the relationship between anaemia and in-hospital, 30-day, 6-month and 1-year mortality, adjusting for age, medical comorbidities, modified Acute Physiology and Chronic Health Evaluation-III and stroke severity. Impact factors were calculated to standardise comparisons between haematocrit tier and other covariates. Results Among n=3750 patients included in the analysis, the haematocrit values were ≤27% in 2.1% (n=78), 28%–32% in 6.2% (n=234), 33%–37% in 17.9% (n=670), 38%–42% in 36.4% (n=1366), 43%–47% in 28.2% (n=1059) and ≥48% in 9.1% (n=343). Patients with haematocrit ≤27%, compared with patients in the 38%–42% range, were more likely to have died across all follow-up intervals, with statistically significant adjusted ORs (aORs) ranging from 2.5 to 3.5. Patients with polycythaemia (ie, haematocrit ≥48%) were at increased risk of in-hospital mortality (aOR=2.9; 95% CI 1.4 to 6.0), compared with patients with mid-range admission haematocrits. Pronounced differences between patients receiving and not receiving blood transfusion limited our ability to perform a propensity analysis. Impact factors in the 1-year mortality model were 0.46 (severe anaemia), 0.06 (cancer) and 0.018 (heart disease). Conclusions Anaemia is independently associated with an increased risk of death throughout the first year post stroke; high haematocrit is associated with early poststroke mortality. Severe anaemia is associated with 1-year mortality to a greater degree than cancer or heart disease. These data cannot address the question of whether interventions targeting anaemia might improve patient outcomes.
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Affiliation(s)
- Jason J Sico
- Neurology Service, VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Department of Neurology, Center for NeuroEpidemiological and Clinical Neurological Research, Yale University School of Medicine, New Haven, Connecticut, USA.,Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.,Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Pain Research, Informatics, Multimorbidities and Education (PRIME) Center of Innovation, VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Laura J Myers
- Communication and the HSR&D Stroke Quality Enhancement Research Initiative (QUERI), Richard L Roudebush VA Medical Center, Indianapolis, Indiana, USA.,VA Health Services Research and Development (HSR&D), Center for Healthcare Informatics, Richard L Roudebush VA Medical Center, Indianapolis, Indiana, USA
| | - Brenda J Fenton
- Pain Research, Informatics, Multimorbidities and Education (PRIME) Center of Innovation, VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Division of Chronic Disease Epidemiology, Yale School of Public Health, West Haven, Connecticut, USA
| | - John Concato
- Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.,Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Medical Service, VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Linda S Williams
- Communication and the HSR&D Stroke Quality Enhancement Research Initiative (QUERI), Richard L Roudebush VA Medical Center, Indianapolis, Indiana, USA.,VA Health Services Research and Development (HSR&D), Center for Healthcare Informatics, Richard L Roudebush VA Medical Center, Indianapolis, Indiana, USA.,Regenstrief Institute, Indianapolis, Indiana, USA.,Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Dawn M Bravata
- Communication and the HSR&D Stroke Quality Enhancement Research Initiative (QUERI), Richard L Roudebush VA Medical Center, Indianapolis, Indiana, USA.,VA Health Services Research and Development (HSR&D), Center for Healthcare Informatics, Richard L Roudebush VA Medical Center, Indianapolis, Indiana, USA.,Regenstrief Institute, Indianapolis, Indiana, USA.,Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA.,Department of Internal Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Chenglong Z, Jing L, Xia K, Yang T. Association of hemoglobin with ankle-brachial index in general population. Clinics (Sao Paulo) 2016; 71:375-80. [PMID: 27464293 PMCID: PMC4946533 DOI: 10.6061/clinics/2016(07)04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 04/13/2016] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Previous studies have demonstrated that both low and high hemoglobin concentrations are predictive of adverse cardiovascular outcomes in various populations. However, an association of hemoglobin with the ankle-brachial index, which is widely used as a screening test for peripheral arterial disease, has not yet been identified. METHODS We examined 786 subjects (236 women and 550 men) who received routine physical check-ups. The ankle-brachial index and several hematological parameters, including the hemoglobin level, hematocrit and red blood cell count and other demographic and biochemical characteristics were collected. Univariate and multivariate linear regression analyses were performed to assess the relationships between the ankle-brachial index and the independent determinants. Receiver operating characteristic curve analysis was conducted to calculate the cut-off level of hemoglobin for detecting a relatively low ankle-brachial index (less than 20% of all subjects, which was 1.02). RESULTS The hemoglobin level, hematocrit and red blood cell count were correlated with the ankle-brachial index in the males (r=-0.274, r=-0.224 and r=-0.273, respectively, p<0.001 for all), but these associations were not significant in the females. Multivariate linear regression analysis revealed that the independent determinants of the ankle-brachial index included age, total cholesterol, high-density lipoprotein cholesterol and the white blood cell count for the females and age, hypertension, total cholesterol and hemoglobin (β=-0.001, p<0.001) for the males after adjusting for confounding factors. Receiver operating characteristic curve analysis revealed that the cut-off level of hemoglobin for predicting a low ankle-brachial index was 156.5 g/L in the males. CONCLUSIONS A high hemoglobin concentration was independently correlated with a low ankle-brachial index in the healthy males, indicating that an elevation in this level may be associated with an increased atherosclerosis risk.
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Affiliation(s)
- Zhang Chenglong
- Central South University, Xiangya Hospital, Department of Cardiology, Changsha, Hunan/China
| | - Lei Jing
- Central South University, Xiangya Hospital, Department of Cardiology, Changsha, Hunan/China
| | - Ke Xia
- Central South University, Xiangya Hospital, Department of Cardiology, Changsha, Hunan/China
| | - Tianlun Yang
- Central South University, Xiangya Hospital, Department of Cardiology, Changsha, Hunan/China
- E-mail:
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Sico JJ, Concato J, Wells CK, Lo AC, Nadeau SE, Williams LS, Peixoto AJ, Gorman M, Boice JL, Bravata DM. Anemia is Associated with Poor Outcomes in Patients with Less Severe Ischemic Stroke. J Stroke Cerebrovasc Dis 2013; 22:271-8. [DOI: 10.1016/j.jstrokecerebrovasdis.2011.09.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Revised: 07/29/2011] [Accepted: 09/01/2011] [Indexed: 11/30/2022] Open
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Clinical manifestation of cancer related stroke: retrospective case-control study. J Neurooncol 2013; 111:295-301. [PMID: 23299460 DOI: 10.1007/s11060-012-1011-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Accepted: 11/20/2012] [Indexed: 12/16/2022]
Abstract
Cancer related stroke may have different phenotypes from non-cancer stroke, especially in terms of stroke progression and recurrence. We performed a case-control study to identify their incidences and risk factors in cancer related stroke. Between January 2001 and December 2009, we conducted a retrospective review of acute ischemic stroke patients with cancer who were admitted to Seoul National University Hospital, Seoul, Korea. The stroke patients without cancer served as control. We collected demographic variables, vascular risk factors, stroke phenotype, clinical course, and cancer information including diagnosis, stage, and treatment status. Among cancer stroke patients, the potential risk factor of stroke recurrence was evaluated. The mean age of the 102 cancer patients was 66.4 ± 10.8 years, and 64.7 % were men. The mean time interval from cancer diagnosis to stroke onset was 39.7 ± 60.9 months. The principal lesion pattern of cancer stroke was multiple dots extending single vascular territory (39.2 %), and they were associated with low hemoglobin and high fibrinogen levels. Stroke progression and recurrence were noted in 9.8 and 27.5 % of cancer stroke patients, and in 9.3 and 12.7 % of control patients, respectively. The stroke subtype was independently associated with recurrence of cancer stroke after multiple logistic regression (odds ratio = 3.165, 95 % confidence interval = 1.080-9.277, p = 0.036). Cancer related stroke has a distinct phenotype in terms of infarction pattern and laboratory findings. Stroke recurrence is frequently observed among cancer stroke patients, and its risk is related with stroke subtype.
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Abstract
Red blood cell transfusion (RBCT) is a common therapy used in the intensive care unit to treat anemia. However, due to deleterious side effects and questionable efficacy, the clinical benefit of RBCT in patients who are not actively bleeding is unclear. The results of randomized controlled trials suggest there is no benefit to a liberal transfusion practice in general critical care populations. Whether the results of these trials are applicable to brain injured patients is unknown, as patients with primary neurological injury were excluded. This article reviews the efficacy and complications of RBCT, as well as the relationship between RBCT and its outcome in both the general intensive care unit and neurologically critically ill populations.
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Affiliation(s)
- Monisha A Kumar
- Department of Neurology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA 19104, USA.
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Abstract
CONTEXT Symptoms and signs consistent with androgen deficiency and low testosterone levels are recognized frequently in clinical practice. Recent population-based epidemiological studies indicate that low testosterone levels in men are associated with increased morbidity and mortality. The clinician must be able to counsel patients to help them determine whether testosterone replacement therapy is appropriate for them. EVIDENCE ACQUISITION The authors have conducted a literature search in PubMed, and we have reviewed references in the multiple systematic reviews and meta-analyses that have been published on this topic. EVIDENCE SYNTHESIS We have attempted to provide the reader with an appreciation of the evidence that can be used to support the diagnosis of androgen deficiency, the efficacy of treatment, the potential risks of treatment, the therapeutic options, and the recommendations for monitoring treatment. CONCLUSIONS We think that published clinical experience justifies testosterone replacement therapy in males who have not initiated puberty by age 14 and in males with low testosterone levels due to classical diseases of the hypothalamic-pituitary-gonadal axis. The benefit:risk ratio is less certain in older men and in those with chronic diseases associated with low testosterone levels. The decision to treat in this setting is much more controversial because there are few large clinical trials that have demonstrated efficacy and no large clinical trials that have determined potential risks of increasing the incidence of clinical prostate cancers or cardiovascular events. We provide a critical review of the evidence that supports treatment and potential risks and ways to reduce the risks if the physician and patient elect testosterone replacement.
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Affiliation(s)
- Glenn R Cunningham
- Baylor College of Medicine and St. Luke's Episcopal Hospital, Houston, Texas 77030, USA.
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Tanne D, Molshatzki N, Merzeliak O, Tsabari R, Toashi M, Schwammenthal Y. Anemia status, hemoglobin concentration and outcome after acute stroke: a cohort study. BMC Neurol 2010; 10:22. [PMID: 20380729 PMCID: PMC2858127 DOI: 10.1186/1471-2377-10-22] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2009] [Accepted: 04/09/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the setting of an acute stroke, anemia has the potential to worsen brain ischemia, however, the relationship between the entire range of hemoglobin to long-term outcome is not well understood. METHODS We examined the association between World Health Organization-defined admission anemia status (hemoglobin<13 in males, <12 g/dl in women) and hemoglobin concentration and 1-year outcome among 859 consecutive patients with acute stroke (ischemic or intracerebral hemorrhage). RESULTS The mean baseline hemoglobin concentration was 13.8 +/- 1.7 g/dl (range 8.1 - 18.7). WHO-defined anemia was present in 19% of patients among both women and men. After adjustment for differences in baseline characteristics, patients with admission anemia had an adjusted OR for all-cause death at 1-month of 1.90 (95% CI, 1.05 to 3.43) and at 1-year of 1.72 (95% CI, 1.00 to 2.93) and for the combined end-point of disability, nursing facility care or death of 2.09 (95% CI, 1.13 to 3.84) and 1.83 (95% CI, 1.02 to 3.27) respectively. The relationship between hemoglobin quartiles and all-cause death revealed a non-linear association with increased risk at extremes of both low and high concentrations. In logistic regression models developed to estimate the linear and quadratic relation between hemoglobin and outcomes of interest, each unit increment in hemoglobin squared was associated with increased adjusted odds of all-cause death [at 1-month 1.06 (1.01 to 1.12; p = 0.03); at 1-year 1.09 (1.04 to 1.15; p < 0.01)], confirming that extremes of both low and high levels of hemoglobin were associated with increased mortality. CONCLUSIONS WHO-defined anemia was common in both men and women among patients with acute stroke and predicted poor outcome. Moreover, the association between admission hemoglobin and mortality was not linear; risk for death increased at both extremes of hemoglobin.
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Affiliation(s)
- David Tanne
- Stroke Center, Department of Neurology, Chaim Sheba medical center, Tel- Hashomer, Israel.
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Irace C, Scavelli F, Carallo C, Serra R, Gnasso A. Plasma and blood viscosity in metabolic syndrome. Nutr Metab Cardiovasc Dis 2009; 19:476-480. [PMID: 19201176 DOI: 10.1016/j.numecd.2008.11.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2008] [Revised: 10/13/2008] [Accepted: 11/14/2008] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND AIM The relationship between metabolic syndrome (MS) and blood and plasma viscosity has been scarcely investigated. In the present study we have evaluated the difference in blood and plasma viscosity between subjects with and without MS, in order to verify whether viscosity measurement can add more information on the overall cardiovascular risk connected with the presence of the MS. METHODS AND RESULTS Two hundred and sixty nine women and 520 men have been enrolled. Blood and plasma viscosity have been measured with a cone-plate viscometer equipped with a cp-40 spindle. MS has been defined according to the third report of the National Cholesterol Education Program, Adult Treatment Panel III. Eighty four women and 154 men fulfilled the criteria for MS. Hematocrit adjusted blood viscosity was higher in subjects with MS compared to those without the syndrome, both in males (shear rate 225 s(-1): 4.60+/-0.38 vs. 4.52+/-0.33 cP, p<0.01) and females (4.57+/-0.28 vs. 4.46+/-0.31 P, p<0.01). Blood viscosity was correlated with all components of MS but glucose, and after adjustment for them the difference between subjects with or without MS was completely abolished. Plasma viscosity was significantly higher only in females with MS. CONCLUSIONS These data demonstrate that blood viscosity is increased in subjects with MS, but the increase seems to depend on the metabolic alterations of the syndrome. The independent contribution of the rise in blood viscosity to the cardiovascular risk connected with the presence of MS seems therefore negligible. The increased plasma viscosity in females with MS needs further clarification.
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Affiliation(s)
- C Irace
- Dipartimento di Medicina Sperimentale e Clinica G. Salvatore, Magna Graecia University, Catanzaro, Italy
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Rasouli M, Kiasari AM, Arab S. INDICATORS OF DEHYDRATION AND HAEMOCONCENTRATION ARE ASSOCIATED WITH THE PREVALENCE AND SEVERITY OF CORONARY ARTERY DISEASE. Clin Exp Pharmacol Physiol 2008; 35:889-94. [DOI: 10.1111/j.1440-1681.2008.04932.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Chen JC, Chen YJ, Chang WP, Christiani DC. Long driving time is associated with haematological markers of increased cardiovascular risk in taxi drivers. Occup Environ Med 2006; 62:890-4. [PMID: 16299099 PMCID: PMC1740933 DOI: 10.1136/oem.2005.020354] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIMS To examine the association between driving time and changes in haematological markers of increased risks for cardiovascular diseases (CVD). METHODS The authors conducted a cross sectional analysis of baseline data from the Taxi Drivers' Health Study cohort in Taipei, Taiwan. They retrieved information on comorbidity, laboratory tests, age, and anthropometric measures from medical records of 1157 subjects (mean age 44.6 (SD 8.6) years). Whole blood cell (WBC) count was used as the primary haematological marker for increased CVD risk, and platelet count and haematocrit as the secondary markers. Standardised questionnaires were implemented to collect information on demographics, lifestyle, work related physical and psychosocial factors, and driving time profiles. Multiple regression was used to estimate the adjusted effects of driving time on three haematological markers. RESULTS The mean measured hematological marker was 6656 (SD 1656) cells x10(6)/l for WBC, 47.2 (SD 3.5) % for hematocrit, and 243 (SD 52) cells x10(9)/l for platelets. The driving time was 264 (SD 76) hours/month. Compared with drivers who drove < or =208 hours/month (1st quartile cut off), drivers who drove >208 hours/month had a higher WBC count (by 317 x10(6)/l; 95% CI 99 to 535), haematocrit (by 0.8%; 95% CI 0.3 to 1.2), and platelets (7.9 x10(9)/l; 95% CI 1.0 to 14.8). After adjusting for conventional CVD risk factors (age, sex, smoking, hypertension, diabetes, and hypercholesterolaemia), obesity, alcohol drinking, regular exercise, and sociodemographics (education, marital status, income, and so on), long driving time was still associated with significant increases in WBC and platelets, whereas the effect on haematocrit was diminished and became statistically non-significant. Additional controls for physical workload, self-perceived job stress, and job dissatisfaction did not alter the associations with increased WBC and platelets. CONCLUSIONS Longitudinal studies are needed to confirm the observed cross sectional association and to further examine the specific occupational exposures accountable for the association between driving time and haematological markers of systemic inflammation and haemostatic alteration.
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Affiliation(s)
- J-C Chen
- Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill, NC 27599, USA.
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Dijk JM, Wangge G, Graaf YVD, Bots ML, Grobbee DE, Algra A. Hemoglobin and atherosclerosis in patients with manifest arterial disease. The SMART-study. Atherosclerosis 2006; 188:444-9. [PMID: 16388808 DOI: 10.1016/j.atherosclerosis.2005.11.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2005] [Revised: 10/12/2005] [Accepted: 11/08/2005] [Indexed: 11/22/2022]
Abstract
BACKGROUND Decreased hemoglobin levels are known to be associated with an increased risk of coronary mortality and morbidity. This is largely thought to result from the development of left ventricular hypertrophy. Similar remodeling mechanisms of the vessel wall that may result in atherosclerosis are likely to be present. We studied whether hemoglobin levels are related to different vascular indicators of atherosclerosis. METHODS AND RESULTS This cross-sectional study was performed in the first consecutive 2514 patients with manifest arterial disease enrolled in the SMART-study (Second Manifestations of ARTerial disease). The relation of hemoglobin levels with common carotid IMT (CIMT), presence of a>/=50% internal carotid artery stenosis (ICAS) and prevalent peripheral arterial disease (PAD) was assessed with linear and logistic regression analyses. Each mmol/l increase in hemoglobin was associated with a lower CIMT (-0.03 mm [95% CI: -0.04; -0.01]) and a lower prevalence of >/=50% ICAS (odds ratio: 0.84 [95% CI: 0.73; 0.97]) after adjustment for age, gender and potential confounders. Hemoglobin was not related to prevalence of peripheral arterial disease (1.02 [95% CI: 0.89; 1.16]). CONCLUSIONS This study shows that in patients with manifest arterial disease, increasing hemoglobin levels are associated with reduced severity of atherosclerosis.
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Affiliation(s)
- J M Dijk
- Julius Center for Health Sciences and Primary Care, University, Medical Center Utrecht (UMCU), Utrecht, The Netherlands
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Madjid M, Awan I, Willerson JT, Casscells SW. Leukocyte count and coronary heart disease. J Am Coll Cardiol 2004; 44:1945-56. [PMID: 15542275 DOI: 10.1016/j.jacc.2004.07.056] [Citation(s) in RCA: 445] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2004] [Revised: 07/10/2004] [Accepted: 07/13/2004] [Indexed: 11/29/2022]
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