| Title | Renal Dysfunction and In-Hospital Outcomes in Patients With Acute Ischemic Stroke After Intravenous Thrombolytic Therapy |
| Authors | Rao, Zhen-Zhen Gu, Hong-Qiu Wang, Xian-Wei Xie, Xue-Wei Yang, Xin Wang, Chun-Juan Zhao, Xingquan Xian, Ying Wang, Yi-Long Li, Zi-Xiao Xiao, Rui-Ping Wang, Yong-Jun Zhao, Jizong Dong, Qiang Wang, Caiyun Zhang, Fuying Xu, Anding |
| Affiliation | Peking Univ, Inst Mol Med, Yingjie Ctr, Beijing, Peoples R China China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China Natl Ctr Healthcare Qual Management Neurol Dis, Beijing, Peoples R China Capital Med Univ, Beijing Tiantan Hosp, Dept Neurol, Vasc Neurol, Beijing, Peoples R China Beijing Key Lab Translat Med Cerebrovasc Dis, Beijing, Peoples R China Beijing Inst Brain Disorders, Ctr Stroke, Beijing, Peoples R China Duke Univ, Med Ctr, Duke Clin Res Inst, Durham, NC USA |
| Keywords | glomerular filtration rate ischemic stroke outcome renal function tissue-type plasminogen activator |
| Issue Date | 2019 |
| Publisher | JOURNAL OF THE AMERICAN HEART ASSOCIATION |
| Abstract | Background-The impact of estimated glomerular filtration rate (eGFR) on clinical short-term outcomes after stroke thrombolysis with tissue plasminogen activator remains controversial. Methods and Results-We analyzed 18 320 ischemic stroke patients who received intravenous tissue plasminogen activator at participating hospitals in the Chinese Stroke Center Alliance between June 2015 and November 2017. Multivariate logistic regression models were used to evaluate associations between eGFR (<45, 45-59, 60-89, and >= 90 mL/min per 1.73 m(2)) and in-hospital mortality and symptomatic intracerebral hemorrhage, adjusting for patient and hospital characteristics and the hospital clustering effect. Of the 18 320 patients receiving tissue plasminogen activator, 601 (3.3%) had an eGFR <45, 625 (3.4%) had an eGFR 45 to 59, 3679 (20.1%) had an eGFR 60 to 89, and 13 415 (73.2%) had an eGFR >= 90. As compared with eGFR >= 90, eGFR values <45 (6.7% versus 0.9%, adjusted odds ratio, 3.59; 95% CI, 2.18-5.91), 45 to 59 (4.0% versus 0.9%, adjusted odds ratio, 2.00; 95% CI, 1.18-3.38), and 60 to 89 (2.5% versus 0.9%, adjusted odds ratio, 1.67; 95% CI, 1.20-2.34) were independently associated with increased odds of in-hospital mortality. However, there was no statistically significant association between eGFR and symptomatic intracerebral hemorrhage. Conclusions-eGFR was associated with an increased risk of in-hospital mortality in acute ischemic stroke patients after treatment with tissue plasminogen activator. eGFR is an important predictor of poststroke short-term death but not of symptomatic intracerebral hemorrhage. |
| URI | http://hdl.handle.net/20.500.11897/553364 |
| ISSN | 2047-9980 |
| DOI | 10.1161/JAHA.119.012052 |
| Indexed | SCI(E) EI |
| Appears in Collections: | 分子医学研究所 |
