Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Hemoglobin Concentration and Clinical Outcomes After Acute Ischemic Stroke or Transient Ischemic Attack
First author：Runhua Zhang
Corresponding author：Gaifen Liu
essential_information
- Person in charge：Runhua Zhang
- Data Sources： CNSR-Ⅲ
- Number of papers：CNSR-Ⅲ20210034
- Published time：2021-11-30
2021-11-30
Published articles
Journal：JAHA
Publication type: Original Contributions
IF(IF): 5.5
PMID: 34845923 Link To Pubmed Full text Download
Background And Purpose
People with low hemoglobin or anemia are more frailty. Low hemoglobin and anemia can increase the risk of stroke. Additionally, anemia may increase of infarct volumes and velocity of infarct growth. Whether low hemoglobin concentration was associated with the outcome in population with stroke? Several studies have demonstrated hemoglobin is associated with all-cause mortality after stroke. However, the data regarding the hemoglobin and functional outcome and recurrent stroke after acute stroke are limited and controversial. In this study, we aimed to estimate the association between hemoglobin concentration and stroke severity and functional outcome and recurrent stroke.
Method
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.
Conclusion
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.
Main results
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.