Journal of Stroke & Cerebrovascular Diseases最新文献

{"title":"Comparison of the associations between Life's Essential 8 and Life's Simple 7 with stroke: NHANES 1999-2018.","authors":"Ye Yuan, Peng Tian, Laifu Li, Qiumin Qu","doi":"10.1016/j.jstrokecerebrovasdis.2025.108238","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2025.108238","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to explore the association between Life's Essential 8 (LE8) and stroke and all-cause mortality, and compare whether it has an advantage over Life's Simple 7 (LS7).</p><p><strong>Methods: </strong>This study investigated data from NHANES spanning from 1999 to 2018. The LE8 was categorized as low, moderate and high cardiovascular health (CVH). LS7 score was categorized as inadequate, average, or optimal. Weighted logistic regression and restricted cubic spline (RCS) were used to examin correlations. Receiver operating characteristic (ROC) curves were employed to detect the accuracy in predicting stroke. The stratified and sensitivity analyses were conducted along with mediation analysis. In addition, a longitudinal cohort was constructed by combining the mortality data, and Cox regression models were utilized to determine the association between CVH and the mortality rate.</p><p><strong>Results: </strong>For LE8, compared to low CVH, moderate CVH was associated with a 41% lower risk of stroke, and high CVH was associated with a 71% lower prevalence of stroke. For LS7, compared to inadequate CVH, average CVH was associated with a 24% lower prevalence of stroke, and optimal CVH was associated with a 39% lower prevalence of stroke. RCS showed inverse dose-response relationships of both LE8 and LS7 with stroke. In unweighted ROC, LE8 (AUC=0.702, 95% CI: 0.685-0.718, P<0.001) has a stronger ability to discriminate stroke than LS7 (0.677, 95% CI: 0.658-0.696, P<0.001) (P_DeLong=0.046). Sensitivity analyses demonstrated robustness of LE8 in predicting stroke. GGT and WBC mediated 4.92% and 4.58% of the association, respectively. Cox regression showed neither LE8 nor LS7 were predictive of mortality risk among stroke survivor.</p><p><strong>Conclusions: </strong>LE8 outperformed LS7 in classifying stroke. Oxidative stress and inflammation mediated the association between LE8 and stroke.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108238"},"PeriodicalIF":2.0,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Systemic Inflammatory Response Index and Cerebral Small Vessel Disease.","authors":"Ting Zhuang, Xiao Xu, Peiyu Huang, Yuqin Zhang","doi":"10.1016/j.jstrokecerebrovasdis.2025.108237","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2025.108237","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore the relationship between the Systemic Inflammatory Response Index (SIRI) and Cerebral Small Vessel Disease (CSVD), focusing on its key imaging markers.</p><p><strong>Methods: </strong>We enrolled 344 patients admitted to the neurology department between January 2022 and September 2024, comprising 223 patients diagnosed with CSVD and 121 without CSVD. Baseline characteristics were compared between groups, and multivariate logistic regression was performed to assess the impact of SIRI on CSVD risk. Further, univariate and multivariate logistic regression analyses were conducted to examine the relationship between SIRI and CSVD imaging markers, including White Matter Hyperintensity (WMH), lacunes, Perivascular Space (PVS), and Recent Small Subcortical Infarct (RSSI).</p><p><strong>Results: </strong>Significant differences were observed between the CSVD and non-CSVD groups in terms of age, sex, history of hypertension, diabetes, white blood cell count, neutrophil count, lymphocyte count, homocysteine levels, and SIRI values. Multivariate analysis confirmed that elevated SIRI is independently associated with an increased risk of CSVD. Additionally, higher SIRI values were linked with more severe CSVD imaging features, including moderate-to-severe WMH, the presence of lacunes, and RSSI.</p><p><strong>Conclusion: </strong>These findings demonstrate that elevated SIRI is independently associated with both the occurrence of CSVD and the severity of key imaging markers such as WMH, lacunes, and RSSI. This suggests that SIRI could serve as a useful inflammatory marker for assessing CSVD risk and progression.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108237"},"PeriodicalIF":2.0,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visual Outcomes of Central Retinal Artery Occlusion: Exploring Treatment Strategies Beyond the Conventional Time Window.","authors":"Chi-Chun Yang, Chang-Chi Weng, Yu-Bai Chou, Yi-Ming Huang, De-Kuang Hwang, Shih-Jen Chen, Tai-Chi Lin","doi":"10.1016/j.jstrokecerebrovasdis.2025.108240","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2025.108240","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>Central retinal artery occlusion (CRAO) is a vision-devastating emergency. However, widely-acknowledged treatment consensus is lacking and prehospital delays commonly occur. Hence, we aimed to investigate the visual outcomes of conservative treatments (CT), local intra-arterial fibrinolysis (LIF) and hyperbaric oxygen (HBO) therapy for non-arteritic CRAO (NA-CRAO) patients beyond the conventional time window.</p><p><strong>Methods: </strong>This retrospective comparative study included 99 NA-CRAO patients followed up for over 6 months. The subjects were divided into three groups: the CT (50 patients), LIF (10 patients) and HBO group (39 patients). The primary endpoint was the best-corrected visual acuity (BCVA) change at 6 months compared to baseline. The secondary endpoint was the improvement in BCVA at 1 year and final visits.</p><p><strong>Results: </strong>No heterogeneity regarding demographics was identified. However, the HBO group had a more extended time-to-treatment period (median 6.0 days) and more advanced-stage CRAO cases (41% stage III) than the CT (median 4.0 days, 14% stage III) and LIF (median 0.6 days, 20% stage III) groups. Despite this, the HBO group exhibited a significantly greater BCVA and a higher proportion of patients achieving significant vision improvement than those in the CT group at 6-, 12-month and final exams (51.3% vs. 24.0%, P<0.05). The LIF appeared to improve outcomes more than CT over time without significance.</p><p><strong>Conclusion: </strong>Our study provided a concurrent comparison across 3 approaches and demonstrated that HBO therapy beyond the time window remained more effective in improving vision than CT alone for NA-CRAO patients, which had not been proposed by prior studies.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108240"},"PeriodicalIF":2.0,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral Air Embolism: Process Change with Unintended Consequences.","authors":"J J Baumann, Michelle Hill, Amy Swank, Ricky Medel","doi":"10.1016/j.jstrokecerebrovasdis.2025.108225","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2025.108225","url":null,"abstract":"<p><strong>Introduction: </strong>During a cerebrovascular procedure, diligent care is made to ensure no air is present in lines and connectors. Should air enter the cerebral vasculature, cerebral air emboli can cause worsening neurological outcome or death. This communication outlines how a process change of refrigerating mixed heparin for storage lead to the presence of unintentional air, or off-gassing of the fluid.</p><p><strong>Material & method: </strong>The off-gassing phenomenon was noted during procedure. Various hypotheses were considered, including manufacturing defect of lines, tubes and fluid preparation. Further investigation identified a new process in mixing of heparin bags and then refrigerated. The off-gassing was noted during the procedure when cold fluid flowed through tubing draped across a warming blanket. This article utilizes the explanatory research method to describe the cause and effect relationship. The aim is to provide knowledge of this phenomenon to prevent future occurrences.</p><p><strong>Result: </strong>Fluids used for neuro endovascular procedures should be warmed to prevent off-gassing, which can lead to cerebral air embolus.</p><p><strong>Conclusion: </strong>Air formation or out-gassing can occur when cold fluids are warmed. During neuro endovascular procedure, this unintentional air can cause significant morbidity or mortality to the patient. Understanding and recognizing this phenomenon is important to prevent patient harm.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108225"},"PeriodicalIF":2.0,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum uric acid levels and intracerebral hemorrhage: a two-sample Mendelian Randomization study.","authors":"Buyou Lu, Xiaorui Sun, Qi Zhong, Zijiu Sun","doi":"10.1016/j.jstrokecerebrovasdis.2024.108192","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2024.108192","url":null,"abstract":"<p><strong>Objective: </strong>Previous observational studies have generated controversy regarding the correlation between serum uric acid (UA) levels and intracerebral hemorrhage (ICH), with the causal relationship remaining uncertain. To assess the potential causal relationship between serum UA levels and ICH, two-sample Mendelian randomization analysis was applied.</p><p><strong>Methods: </strong>Single-nucleotide polymorphisms (SNPs) closely associated with serum UA were retrieved from the genome-wide association study (GWAS) database, including 580,505 individuals of European descent. A total of 27 and 251 SNPs were chosen as instrumental variables. Summary data for ICH included 1935 cases and 471,578 controls. Two-sample MR analyses, including inverse-variance weighted (IVW), MR-Egger, weighted median, and weighted mode methods, were employed to assess the potential causal relationship between serum UA levels and ICH, with odds ratios (ORs) as effect estimates. Heterogeneity was evaluated using Cochran's Q test, and sensitivity analyses were conducted using the leave-one-out method.</p><p><strong>Results: </strong>The IVW analysis revealed that a 1 mg/dL increase in serum UA was associated with a 16.5% higher risk of ICH (OR 1.165, 95% CI 1.01-1.34, P=0.034), while a 1 quantile increase in serum UA was associated with a 25.9% higher risk (OR 1.259, 95% CI 1.091-1.46, P=0.002). Cochran's Q test showed no evidence of heterogeneity. No horizontal pleiotropy was detected. The sensitivity analysis using the leave-one-out method supported the robustness and reliability of our results.</p><p><strong>Conclusion: </strong>The study reveals that elevated serum UA levels are causally linked to ICH, suggesting the potential applicability of serum UA as a biomarker for the occurrence of ICH.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108192"},"PeriodicalIF":2.0,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor regarding \"Electroacupuncture improves vascular cognitive impairment no dementia: A Randomized Clinical Trial\".","authors":"Yuxin Wu, Yi Liang","doi":"10.1016/j.jstrokecerebrovasdis.2025.108235","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2025.108235","url":null,"abstract":"","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108235"},"PeriodicalIF":2.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sickness absence and disability pension in patients treated with mechanical thrombectomy.","authors":"Mihae Roland, Ann-Sofie Rudberg, Fabian Arnberg, Kristina Alexanderson, Christina Sjöstrand","doi":"10.1016/j.jstrokecerebrovasdis.2025.108236","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2025.108236","url":null,"abstract":"<p><strong>Background: </strong>Stroke patients with large vessel occlusions risk long-term or permanent sickness absence. We aimed to analyze the proportions and days of sickness absence and disability pension in thrombectomy-treated patients.</p><p><strong>Methods: </strong>A register-based nationwide longitudinal cohort study of stroke patients treated with mechanical thrombectomy in 2016-2021 in Sweden (identified through the Swedish Board of Health and Welfare procedural code for care interventions, KVÅ:AAL15). All thrombectomy treated patients aged 18-63 were followed one year prior and one after stroke. Proportions (%) and number of net days of sickness absence and disability pension were calculated. Predictors for absence were calculated through multinomial regression analysis.</p><p><strong>Results: </strong>We included 672 patients, mean age was 53 years and 66% were men. The proportion of patients on sickness absence decreased from 70.4% at 30 days to 63.2% at 90 days after stroke onset. Proportions of sickness absence and disability pension did not differ between women and men after treatment. Amongst predictors for having full-time absence at 90 days were: OR (95% CI) being born in Europe (excl. Nordic countries) 2.17 (1.15-4.11), being single 1.59 (1.12-2.26), elementary education 2.08 (1.21-3.57), and living in a town or suburb 1.47 (1.01-2.14). Patients with no income 0.21 (0.13-0.35) or the lowest income level 0.36 (0.22-0.58) had low odds for full-time sickness absence and disability pension at 90 days.</p><p><strong>Conclusions: </strong>One third of thrombectomy-treated patients had no sickness absence nor disability pension at day 30 after stroke, and the proportion of patients without absence increased during follow-up. Absence proportions and predictors for full-time absence were centered around income level, educational level, birth country, and type of living area. Notably, there were no sex differences.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108236"},"PeriodicalIF":2.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"3DSlicer Software-Assisted Neuroendoscopic Surgery Compared with Traditional Surgery on Surgical Effects, Complications, and Safety Evaluation in Patients with Intracerebral Hemorrhage: A Systematic Review and Meta-Analysis.","authors":"Jin Han, Zhitong Han, Ruijian Zhang, Peng Sun, Yanna Zhang, Yucong Yao","doi":"10.1016/j.jstrokecerebrovasdis.2025.108226","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2025.108226","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to comprehensively evaluate the complications, effectiveness, and safety of neuroendoscopic surgery (NS) assisted by 3DSlicer software, compared to traditional surgery in patients with intracerebral hemorrhage (IH).</p><p><strong>Methods: </strong>We searched for case-control trials from the Chinese Biomedical Literature data (CBM) online database, Wanfang Database, EMBASE, VIP Full-text Database, China National Knowledge Infrastructure (CNKI), Science Direct, Cochrane Library, and PubMed. The studies, published since January 2010, involved NS or traditional surgery for IH patients assisted by 3DSlicer software. Data were independently retrieved by two researchers, and the risk of bias in each study was evaluated using the Cochrane Handbook 5.3 standard.</p><p><strong>Results: </strong>A total of 591 patients from seven controlled clinical studies were included. Fixed-effect model analysis revealed a significantly higher treatment effectiveness rate in the study group (SG) (P < 0.05). Random-effects model (REM) analysis indicated that the operation time in the SG was significantly shorter (P < 0.05). Furthermore, the SG group experienced significantly shorter hospitalization time (P < 0.05). NIHSS scores in the SG were notably lower (P < 0.05). Fixed-effect model analysis also showed that the incidence of postoperative complications in the SG was significantly lower (P < 0.05).</p><p><strong>Conclusion: </strong>Neuroendoscopic surgery assisted by 3DSlicer software is more effective in treating IH, enhancing prognosis, improving neurological function, and reducing complication rates. This approach appears to be a promising candidate for clinical adoption.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108226"},"PeriodicalIF":2.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Efficacy and Safety of Tissue Plasminogen Activators (tPA) in Acute Ischemic Stroke: A Systematic Review and Network Meta-analysis of Randomized Controlled Trials.","authors":"Sufyan Shahid, Humza Saeed, Minahil Iqbal, Ayesha Batool, Muhammad Bilal Masood, Muhammad Husnain Ahmad, Aqeeb Ur Rehman, Muhammad Aemaz Ur Rehman, Fahd Sultan","doi":"10.1016/j.jstrokecerebrovasdis.2025.108230","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2025.108230","url":null,"abstract":"<p><strong>Background: </strong>Intravenous alteplase (ALT) is the standard treatment for acute ischemic stroke (AIS). However, recent trials comparing other tissue plasminogen activators (tPAs) like tenecteplase (TNK) and reteplase with ALT have yielded conflicting results. This necessitated a network meta-analysis to compare the efficacy and safety of various tPAs in AIS patients.</p><p><strong>Methods: </strong>We searched MEDLINE, Embase, and CENTRAL (until September 15, 2024) for randomized controlled trials (RCTs) comparing TNK or reteplase (any dose) with ALT (0.9 mg/kg) in AIS patients. A frequentist network meta-analysis was performed using risk ratio (RR) and 95% CI for each comparison, and P-scores ranked treatments. Analyses were done using R Software 4.2.3.</p><p><strong>Results: </strong>Sixteen RCTs (9259 patients, 62.1% males) were included. Reteplase 18+18 mg significantly improved excellent functional recovery (mRS 0-1) (RR: 1.13; p<0.01) and independent ambulation (mRS 0-2) at 3 months (RR: 1.07; p<0.01) compared to ALT. The 0.25 mg/kg TNK group also showed improved functional recovery (mRS 0-1) (RR: 1.06; p<0.01). For safety, 0.1 mg/kg TNK was associated with a higher incidence of symptomatic intracranial hemorrhage (s-ICH) (RR: 7.27; p<0.01). No significant differences in ICH or all-cause mortality were found between ALT and other treatments. Reteplase 18+18 mg ranked highest for functional recovery (P-score=0.9638) and ambulation (P-score=0.9749), while ALT ranked highest for s-ICH (P-score=0.8060). No significant differences were observed between reteplase and TNK.</p><p><strong>Conclusion: </strong>Reteplase 18+18 mg and TNK 0.25 mg/kg demonstrated higher efficacy and comparable safety to ALT. Larger trials are needed to further explore these agents as alternatives to ALT.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108230"},"PeriodicalIF":2.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating Causal Associations of Gut Microbiota and Blood Metabolites on Stroke and its Subtypes: A Mendelian Randomization Study.","authors":"Ruijie Zhang, Liyuan Han, Liyuan Pu, Guozhi Jiang, Qiongfeng Guan, Weinv Fan, Huina Liu","doi":"10.1016/j.jstrokecerebrovasdis.2025.108233","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2025.108233","url":null,"abstract":"<p><strong>Background: </strong>The causal relationships between gut microbiota, blood metabolites, and stroke and its subtypes remain unclear. This study aims to uncover the causal associations using Mendelian randomization.</p><p><strong>Methods: </strong>We initially identify Single-Nucleotide Polymorphisms (SNPs) correlated with gut microbiota and blood metabolites as instrumental variables (IVs) from the summary statistics in Genome-Wide Association Study (GWAS) to evaluate their potential causal associations with stroke and its subtypes. We proceed with a two-step Mendelian randomization analysis aiming to determine whether blood metabolites mediate the relationships between gut microbiota and stroke or its subtypes.</p><p><strong>Results: </strong>We identified the genetic predictions of 12, 11, and 10 particular gut microbiota were associated with stroke, ischemic stroke, and intracerebral hemorrhage respectively. Inverse variance weighted (IVW) analysis disclosed Alistipes (OR [95%CI]: 1.11[1.00,1.23]), Streptococcus (OR [95%CI]: 1.17[1.05,1.30]), and Porphyromonadaceae (OR [95%CI]: 2.41[1.09,5.31]) as the primary causal effects on stroke, ischemic stroke, and ICH, respectively. We determined that 8, 11, and 1 blood metabolites were causally related to stroke, ischemic stroke, and ICH, respectively. Among these metabolites, Citrate (OR [95%CI]: 2.39[1.32,4.34]) and Beta-hydroxyisovalerate (OR [95%CI]: 2.54[1.62,3.97]) had the foremost causal effect on stroke and ischemic stroke, respectively, whereas Glutaroyl carnitine evidenced a causal effect on ICH. Furthermore, our study revealed that Tetradecanedioate marginally mediated the causal effects of Paraprevotella on stroke and ischemic stroke.</p><p><strong>Conclusions: </strong>This study established a causal link between gut microbiota, plasma metabolites, and stroke. It revealed a marginal pathway, shedding new light on the intricate interactions among gut microbes, blood metabolites, stroke, and their underlying mechanisms.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108233"},"PeriodicalIF":2.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}