Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Disease

Tianjin, China

Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Disease

Tianjin, China
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Hong Y.,Tianjin Huanhu Hospital | Hong Y.,Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Disease | Yang X.,Tianjin Huanhu Hospital | Yang X.,Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Disease | And 14 more authors.
Frontiers in Neurology | Year: 2017

Atrial fibrillation (AF) significantly increases the risk of stroke and disease burden and is an established predictor of poor outcomes after stroke. However, data regarding sex differences in long-term outcomes following stroke in patients with AF are scarce. We thus aimed to assess these differences. We recruited 951 consecutive patients with acute ischemic stroke and non-valvular atrial fibrillation (NVAF) treated at three hospitals in Tianjin, China, from January 2006 to September 2014. Information regarding stroke subtype, severity, risk factors, and outcomes (mortality, dependency, and recurrence) at 3, 12, and 36 months after stroke was recorded. The prevalence of NVAF was 8.4% overall, with a higher frequency in women than in men (11.3 vs. 6.9%, P < 0.001). Among patients with NVAF, women were older than men. Women were more likely than men to have severe stroke (38.8 vs. 29.5%, P < 0.001), high levels of total cholesterol and high- and low-density lipoprotein cholesterol (all P < 0.001), hypertension (69.1 vs. 61.2%, P = 0.012), dyslipidemia (29.8 vs. 20.7%, P = 0.001), and obesity (18.5 vs. 11.6%, P = 0.003); they were less likely than men to be current smokers (12.2 vs. 33.6%, P < 0.001) and to consume alcohol (0.9 vs. 13.9%, P < 0.001). There were greater risks of dependency and recurrence at 36 months after stroke in women than in men [odds ratios (95% confidence intervals), 1.64 (1.02-2.64) for dependency, P = 0.043; and 2.03 (1.28-3.20) for recurrence, P = 0.002] after adjustment for stroke subtype, severity, and risk factors. These findings suggest that it is crucial to emphasize the need for individualized stroke prevention education and promotion of healthy lifestyles in order to improve NVAF-related stroke outcomes and reduce disease burden in women. © 2017 Hong, Yang, Zhao, Zhang, Zhao, Yang, Ning, Wang and An.


Zhao W.,Tianjin Huanhu Hospital | Zhao W.,Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Disease | An Z.,Tianjin Huanhu Hospital | An Z.,Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Disease | And 12 more authors.
BMC Neurology | Year: 2016

Background: Total cholesterol is a well-documented risk factor for coronary disease. Previous studies have shown that high total cholesterol level is associated with better stroke outcomes, but the association of low total cholesterol levels and ischemic stroke outcomes is rare. Therefore, we aimed to assess the association of low total cholesterol levels and stroke outcomes among acute ischemic stroke patients in China. Methods: This study recruited 6407 atherothrombotic infarction patients from Tianjin, China, between May 2005 and September 2014. All patients were categorized into five groups according to TC level quintiles at admission. Differences in subtypes, severity, risk factors, and outcomes at 3, 12, and 36 months after stroke were compared between these groups. Results: In total, 1256 (19.6 %) patients had low cholesterol levels, with a higher prevalence in men than in women (23.7 % vs. 11.2 %, P < 0.001). Compared with higher cholesterol levels, the lowest cholesterol level quintile (TC, <4.07 mmol/L) was associated with older age (64.7 years, P = 0.033), anterior circulation infarct (22.8 %), atrial fibrillation (4.9 %), current smoking (41.1 %), and alcohol consumption (21.1 %) and lower frequencies of hypertension (72.9 %), diabetes (30.7 %), and obesity (9.9 %). Dependency and recurrence rates were significantly higher at 36 months in patients in the lowest TC level quintile than in those with higher cholesterol levels (dependency rates, 51.2 % vs 45.2 %; P = 0.007 and recurrence rates, 46.3 % vs 37.3 %, P = 0.001). Moreover, these differences remained after adjustment for age, sex, stroke severity, and Oxfordshire Community Stroke Project classification (odds ratios [ORs] for dependency rate, 1.41; 95 % confidence interval [CI], 1.11, 1.79; P = 0.005 and recurrence rate, 1.50; 95 % CI, 1.19, 1.89; P = 0.001). However, mortality rates after stroke were not significantly different between the groups. Conclusions: These findings suggest that statin treatment for patients with atherothrombotic infarction and low cholesterol levels increase long-term dependency and recurrence rates, but do not increase mortality rates. It is crucial to highlight the different impact of statin treatment on patients with atherothrombotic infarction and lower cholesterol levels for secondary stroke prevention in China. © 2016 Zhao et al.


PubMed | Tianjin Medical University, Tianjin Huanhu Hospital and Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Disease
Type: | Journal: BMC neurology | Year: 2016

Total cholesterol is a well-documented risk factor for coronary disease. Previous studies have shown that high total cholesterol level is associated with better stroke outcomes, but the association of low total cholesterol levels and ischemic stroke outcomes is rare. Therefore, we aimed to assess the association of low total cholesterol levels and stroke outcomes among acute ischemic stroke patients in China.This study recruited 6407 atherothrombotic infarction patients from Tianjin, China, between May 2005 and September 2014. All patients were categorized into five groups according to TC level quintiles at admission. Differences in subtypes, severity, risk factors, and outcomes at 3, 12, and 36 months after stroke were compared between these groups.In total, 1256 (19.6%) patients had low cholesterol levels, with a higher prevalence in men than in women (23.7% vs. 11.2%, P<0.001). Compared with higher cholesterol levels, the lowest cholesterol level quintile (TC, <4.07 mmol/L) was associated with older age (64.7 years, P=0.033), anterior circulation infarct (22.8%), atrial fibrillation (4.9%), current smoking (41.1%), and alcohol consumption (21.1%) and lower frequencies of hypertension (72.9%), diabetes (30.7%), and obesity (9.9%). Dependency and recurrence rates were significantly higher at 36 months in patients in the lowest TC level quintile than in those with higher cholesterol levels (dependency rates, 51.2% vs 45.2%; P=0.007 and recurrence rates, 46.3% vs 37.3%, P=0.001). Moreover, these differences remained after adjustment for age, sex, stroke severity, and Oxfordshire Community Stroke Project classification (odds ratios [ORs] for dependency rate, 1.41; 95% confidence interval [CI], 1.11, 1.79; P=0.005 and recurrence rate, 1.50; 95% CI, 1.19, 1.89; P=0.001). However, mortality rates after stroke were not significantly different between the groups.These findings suggest that statin treatment for patients with atherothrombotic infarction and low cholesterol levels increase long-term dependency and recurrence rates, but do not increase mortality rates. It is crucial to highlight the different impact of statin treatment on patients with atherothrombotic infarction and lower cholesterol levels for secondary stroke prevention in China.

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