In:
Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 53, No. Suppl_1 ( 2022-02)
Abstract:
Background: Impaired kidney function increases the risk of vascular events in stroke patients, when assessed by single measurements of serum creatinine and estimated glomerular filtration rate (eGFR). Whether repeated measurements improve risk prediction in acute stroke patients is unknown. Methods: The investigator-initiated, prospective, multicenter Systematic Monitoring for Detection of Atrial Fibrillation in Patients with Acute Ischemic Stroke study randomized 3,465 acute ischemic stroke patients without known AF to usual diagnostic procedures for detecting AF or an additive Holter-ECG. eGFR was estimated by the CKD-Epi formula. Dynamics of eGFR during hospitalization was categorized as “stable ≥60ml/min”, “rising” (by at least 15% from any baseline value), “falling” (by at least 15% and baseline eGFR≥60ml/min) and “stable 〈 60ml/min”. Recurrent stroke, major bleed, myocardial infarction, and all-cause death within 24 months were assessed as a composite endpoint. We estimated hazard ratios in confounder adjusted models. Results: The dynamics of eGFR were available in 1,623 patients. In 1,001 (61.7%) eGFR was “stable≥60ml/min”, in 231 (6.7%) “rising”, in 74 (4.6%) “falling”, and in 317 (19.5%) “stable 〈 60ml/min”. After Adjusting for age, stroke severity, cardiovascular risk factors, and randomization, “falling” (HR 1.79; 95%CI 1.07-2.99) and “stable 〈 60ml/min” eGFR (HR 1.64; 95%CI 1.20-2.24) correlated significantly with the composite endpoint, while only “falling” eGFR was associated with all-cause death (HR 3.12; 95%CI 1.63-5.98). Conclusions: Hospitalized ischemic stroke patients with a falling eGFR (of at least 15%, baseline ≥60ml/min) are at similar risk for recurrent vascular events or death and at higher risk for death as stroke patients with constantly reduced kidney function. Repeated estimates of eGFR may therefore improve risk prediction.
Type of Medium:
Online Resource
ISSN:
0039-2499
,
1524-4628
DOI:
10.1161/str.53.suppl_1.WP214
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2022
detail.hit.zdb_id:
1467823-8
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