Journal of Stroke & Cerebrovascular Diseases最新文献

{"title":"Predictors of Outcome in Patients with Presumed Reversible Cerebral Vasoconstriction Syndrome (RCVS).","authors":"Adrusht Madapoosi, Laura Stone McGuire, Angelica Fuentes, Anthony Sanchez-Forteza, Mpuekela Tshibangu, Peter Theiss, Tatiana Abou Mrad, Sepideh Amin-Hanjani, Ali Alaraj","doi":"10.1016/j.jstrokecerebrovasdis.2025.108234","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2025.108234","url":null,"abstract":"<p><strong>Introduction: </strong>Reversible cerebral vasoconstriction syndrome (RCVS) is thought to be benign by nature, but a proportion of patients still suffer from neurological deficits on follow-up.</p><p><strong>Objective: </strong>To understand what factors may influence a patient's recovery from RCVS.</p><p><strong>Methods: </strong>The Clinical Research Data Warehouse at this institution was employed to search the medical records for patients with diagnosis and treatment of RCVS (2010-2021). After screening, 85 patients met inclusion criteria for a presumed diagnosis of RCVS with reported follow-up data. Patients were assessed by discharge modified Rankin Scale (mRS), which was grouped as lower (0 or 1) (n=54) and higher (2 to 6) (n=31). Clinical and radiographic data were analyzed.</p><p><strong>Results: </strong>Median follow-up time was 80.0 (36.3-136) days for the lower discharge mRS group and 89.0 (39.0-179) days for the higher discharge mRS group. There were more females in the lower discharge mRS group (p=0.027). Multivariate analysis selected sex (OR 0.220, 95% CI 0.068-0.709) and headache on presentation (OR 0.071, 95% CI 0.017-0.288) as predictive of lower discharge mRS, and a history hypertension (HTN) ([OR], 5.24 [95% CI, 1.65 - 16.7]), IPH on presentation ([OR], 8.21 [95% CI, 1.65 - 40.8]), and AMS on presentation ([OR], 25.8 [95% CI, 4.75 - 140]) as predictive of higher discharge mRS.</p><p><strong>Conclusion: </strong>Female sex and headache are associated with lower discharge mRS, while a history of HTN, IPH, and altered mental status are associated with higher discharge mRS. Future studies with larger sample size may help elucidate factors associated with poor neurological outcome.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108234"},"PeriodicalIF":2.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973314","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":"Thromboelastography may assess the effect of anticoagulation reversal in intracranial hemorrhage.","authors":"A Zepeski, B A Faine, M Ghannam, H M Olalde, L Wendt, A Naidech, N M Mohr, E C Leira","doi":"10.1016/j.jstrokecerebrovasdis.2025.108228","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108228","url":null,"abstract":"<p><strong>Background: </strong>Intracranial hemorrhage (ICH) is a complication of oral anticoagulation and is associated with significant morbidity and mortality. Clinical need exists for biomarkers to measure anticoagulation in patients with factor Xa inhibitor-associated ICH to assess the hemostatic effect of reversal agents. This study explored the utility of thromboelastography (TEG) to assess anticoagulation in emergency department (ED) patients who received activated prothrombin complex concentrate (aPCC) reversal for factor Xa-inhibitor-associated ICH.</p><p><strong>Methods: </strong>This was a prospective, single-center, cohort study in a convenient sample of adult patients presenting to the ED with acute factor Xa-associated ICH. Exclusion criteria included pregnancy, incarceration, polytrauma, hepatic failure, or other known coagulopathic conditions. TEG samples were collected prior to anticoagulation reversal, as well as at 30-minutes, 12-hours, and 24-hours post-reversal. Only patients who received aPCC reversal were included in the final analysis.</p><p><strong>Results: </strong>Pre-reversal TEG was collected on 10 participants prior to aPCC administration. A significant decrease in TEG R-time was observed at 30 minutes post-aPCC reversal (Beta = -0.91, p = 0.035). R-time increased at 12- and 24-hours post-aPCC reversal to baseline levels. Significant changes were not observed in K-time, clot strength, maximum amplitude, or coagulation index.</p><p><strong>Conclusions: </strong>TEG R-time decreases acutely after anticoagulation reversal with aPCC and rebounds at 12- and 24-hours post-reversal. TEG R-time may serve as a potential sensitive biomarker of the residual anticoagulation activity of factor Xa inhibitors in patients with ICH that undergo anticoagulation reversal with aPCCs.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108228"},"PeriodicalIF":2.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967101","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 \"Iatrogenic cerebral amyloid angiopathy: Two case reports to explore clinical heterogeneity and pathological patterns\" recently published by Vera-Cáceres and colleagues.","authors":"Matija Zupan, Janja Pretnar Oblak, Senta Frol","doi":"10.1016/j.jstrokecerebrovasdis.2025.108232","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2025.108232","url":null,"abstract":"","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108232"},"PeriodicalIF":2.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967189","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":"Trajectory of Depressive Symptoms in a Longitudinal Stroke Cohort.","authors":"Katherine Sewell, Tamara Tse, Leonid Churilov, Thomas Linden, Sheila Crewther, Henry Ma, Stephen M Davis, Geoffrey A Donnan, Leeanne M Carey","doi":"10.1016/j.jstrokecerebrovasdis.2024.108197","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2024.108197","url":null,"abstract":"<p><strong>Objectives: </strong>Knowledge of the trajectory of post-stroke depression is important to identify high-risk patients, develop precise management programs and enhance prognosis. We aimed to characterise the course of depressive symptoms within the first year post-stroke and to evaluate associations with time.</p><p><strong>Materials and methods: </strong>Depressive symptoms were measured using the Montgomery-Åsberg Depression Rating Scale (MADRS) within the first week, and at 3- and 12-months post-stroke. Scores were dichotomised into symptoms 'present' (MADRS ≥ 7) or 'absent' (MADRS < 7). The course of depressive symptoms within individuals was mapped and categorised using a trajectory diagram. The association between time and the presence of depressive symptoms was investigated using random effects logistic regression. Logistic regression was also used to assess the likelihood of participants having depressive symptoms later, given their status at earlier time points.</p><p><strong>Results: </strong>Of 142 ischaemic stroke survivors included for analysis, almost half (47.9%) experienced a change in depressive symptom status over time. Depressive symptoms were common at each timepoint (35-43%), although an association between time and frequency of depressive symptoms was not evident. Stroke survivors with depressive symptoms at 3 months were more likely to have depressive symptoms at 12 months, compared to those without symptoms at 3 months.</p><p><strong>Conclusion: </strong>Our findings provide evidence for a dynamic trajectory of depressive symptoms in individuals in the first year post-stroke. The importance of repeated screening for depression is highlighted, though most necessary at 3 months post-stroke.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108197"},"PeriodicalIF":2.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958877","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":"Compromised cerebrovascular reactivity related to presence of white matter hyperintensities in cryptogenic stroke with right-to-left shunts.","authors":"Huizhen Song, Shuang Zhang, Qianqian Xie, Zhoujie Zhu, Linger Li, Hongqin Zhao","doi":"10.1016/j.jstrokecerebrovasdis.2025.108223","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108223","url":null,"abstract":"<p><strong>Objective: </strong>This study investigates cerebrovascular reactivity (CVR) changes in cryptogenic stroke (CS) patients with right-to-left shunts (RLS) and evaluates the relationship between CVR and white matter hyperintensities (WMHs).</p><p><strong>Methods: </strong>The breath-holding index (BHI), representing CVR, was measured from the middle cerebral artery (MCA) using the breath-holding method. WMHs were defined as clearly hyperintense areas on 3T magnetic resonance imaging (MRI), assessed separately as periventricular hyperintensities (PVH) and deep white matter hyperintensities (DWMH). RLS was diagnosed based on a contrast-enhanced transcranial Doppler (c-TCD) examination.</p><p><strong>Results: </strong>Among 260 CS patients and 128 controls, BHI was significantly lower in CS groups (0.68±0.27 vs. 0.83±0.31, P<0.001), particularly in those with RLS (0.64±0.28 vs. 0.71±0.25,P = 0.030). CS patients with WMHs exhibited lower BHI than those without WMHs (0.50±0.22 vs.0.60±0.35, P = 0.012), and PVH showed lower BHI compared to DWMH (0.45±0.24 vs.0.58±0.16, P = 0.003). A negative correlation was found between WMH severity and BHI (0.60±0.35 vs.0.51±0.21 vs.0.48±0.20 vs.0.38±0.28, P = 0.025). Reduced BHI was an independent risk factor for WMHs (OR = 0.283; 95 % CI = 0.081-0.995, P = 0.049).</p><p><strong>Conclusion: </strong>CS patients, especially those with RLS, show reduced CVR, which correlates with the location and severity of WMHs. These findings suggest that RLS may significantly contribute to WMH development in CS patients.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108223"},"PeriodicalIF":2.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958876","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":"Global prevalence and risk factors of delirium among patients following acute stroke: A systematic review and meta-analysis.","authors":"Muhammad Amirul Mukminin, Tu-Hsueh Yeh, Hui-Chen Lin, Iftitakhur Rohmah, Hsiao-Yean Chiu","doi":"10.1016/j.jstrokecerebrovasdis.2024.108221","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108221","url":null,"abstract":"<p><strong>Background and objective: </strong>The exact prevalence and risk factors of delirium following stroke at an acute stage remains unclear. We aimed to determine the global prevalence and risk factors of delirium following acute stroke.</p><p><strong>Method: </strong>Observational studies reporting the prevalence of or risk factors for delirium following acute stroke published in the PubMed, Embase, and Scopus databases before April 16, 2024, were identified. Data were extracted by two independent reviewers. A random effects model was used for data analysis.</p><p><strong>Results: </strong>Our meta-analysis included 48 studies on prevalence and 25 studies on risk factors for poststroke delirium. The pooled global prevalence rate of delirium was 24 % (18 %-30 %). Hemorrhagic stroke type, early assessment (within 3 days of stroke onset), older age, and male sex were risk factors for poststroke delirium. Independent factors significantly associated with poststroke delirium (all p < 0.05) were age, dementia, prior stroke, prior total anterior circulation infarct stroke subtype, atrial fibrillation, elevated C-reactive protein levels, aphasia, poor vision, neglect, depression, and the use of urinary catheters and gastric tubes.</p><p><strong>Conclusion: </strong>Approximately a quarter of the included patients with acute stroke experienced delirium. Our findings regarding the risk factors for poststroke delirium can provide an evidence-based approach for future strategies to prevent delirium.</p><p><strong>Fundings: </strong>NSTC, Taiwan (MOST 113-2628-B- 038-00-MY3 and 111-2314-B-038-033-MY3).</p><p><strong>Protocol: </strong>The International Prospective Register of Systematic Reviews (CRD42024518119).</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108221"},"PeriodicalIF":2.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933502","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":"P2Y12 inhibitors plus aspirin versus aspirin alone in patients with ischemic cerebrovascular events: An updated meta-analysis of randomized controlled trials.","authors":"Hilária Saugo Faria, Rian Barreto Arrais Rodrigues de Morais, Elísio Bulhões, Lucas Cael Azevedo Bendaham, Ocílio Ribeiro Gonçalves, João Lucas de Magalhães Leal Moreira, Victor Gonçalves Soares, Marianna Leite, Christian Ferreira, Márcio Yuri Ferreira, Yafell Serulle","doi":"10.1016/j.jstrokecerebrovasdis.2024.108180","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2024.108180","url":null,"abstract":"<p><strong>Background: </strong>The efficacy and safety of P2Y12 inhibitors (P2Y12i) with aspirin in patients with non-cardioembolic ischemic cerebrovascular events remains a topic of ongoing debate. Therefore, we conducted an updated meta-analysis to compare these drugs with aspirin alone.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, and Cochrane Central for randomized controlled trials (RCTs) comparing the two treatment regimens in patients with ischemic cerebrovascular events. Primary outcomes were all-cause mortality, severe bleeding, and stroke recurrence. We performed subgroup analyses stratified by National Institutes of Health Stroke Scale (NIHSS). Risk ratios (RRs) with 95 % confidence intervals were calculated using a random effects model. R software (version 4.3.2) was used for statistical analyses.</p><p><strong>Results: </strong>Fifteen studies were included, comprising 38,851 patients, of whom 19,483 (50.1 %) received P2Y12i plus aspirin. Follow-up ranged from 7 days to 3.4 years. P2Y12i plus aspirin significantly reduced stroke recurrence (RR 0.78; 95 % CI = 0.71-0.87; p < 0.05), but increased the incidence of all-cause mortality (RR 1.38; 95 % CI = 1.11-1.72; p < 0.05) and severe bleeding (RR 2.07; 95 % CI 1.61 to 2.66; p > 0.05) compared with aspirin. There was no significant difference between groups in all-cause mortality in patients with NIHSS ≤3 or ≤10.</p><p><strong>Conclusion: </strong>P2Y12i plus aspirin reduced stroke recurrence, but increased all-cause mortality and severe bleeding in patients with non-cardioembolic ischemic events. There was no difference between groups in all-cause mortality in patients with NIHSS scores ≤3 or ≤10.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 2","pages":"108180"},"PeriodicalIF":2.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928648","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":"LDL-cholesterol lowering agents (statins and PCSK9 inhibitors) and the risk of intracerebral hemorrhage: A network meta-analysis.","authors":"Wangwen Li, Chuyue Wu, Wenkui Li, Li Li","doi":"10.1016/j.jstrokecerebrovasdis.2025.108224","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108224","url":null,"abstract":"<p><strong>Background and purpose: </strong>Statin therapy reduces the risk of ischemic stroke; however, certain studies have observed an increased incidence of intracerebral hemorrhage (ICH). Moreover, proprotein convertase subtilisin/kexin type 9(PCSK-9) inhibitors have emerged as a powerful class of lipid-lowering medications, potentially with a lower propensity for causing hemorrhagic events. To investigate this matter further, we conducted a network meta-analysis of randomized controlled trials (RCTs) involving statins and PCSK-9 inhibitors that reported occurrences of ICH.</p><p><strong>Methods: </strong>We performed a literature search of Medline, Web of Science, and The Cochrane Library from database inception until August 2023. All randomized controlled trials of statin therapy and PCSK-9 inhibitors that reported ICH or hemorrhagic stroke were included. The primary outcome variable was ICH. The risk of bias of each included study was assessed by using the Cochrane Handbook for Systematic Reviews of Interventions. We performed network meta-analysis to compare and rank statin and PCSK-9 inhibitors therapies. This study is registered (2023110026. inplasy.com).</p><p><strong>Results: </strong>A total of 26251 citations were identified by the search, and 38 potentially eligible articles were included. In total, data from 271411 individuals were analyzed. The data showed that there was not a significant increased risk of intracerebral hemorrhage for all statins and PCSK-9 inhibitors compared with placebo. atorvastatin and rosuvastatin were associated with a lower risk of death than placebo (ORs ranging between 0.79 and 0.82). For risk of intracerebral hemorrhage and mortality. there was not a significant increased risk among all drugs.</p><p><strong>Conclusions: </strong>LDL-Cholesterol lowering agents (statins and PCSK-9 inhibitors) was not associated with a significant increased risk of ICH. Our network meta-analysis provides strong evidence for the safety of statins and PCSK-9 inhibitors, but more studies are needed to further validate this conclusion.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108224"},"PeriodicalIF":2.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928767","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 prognostic nutritional index and stroke: A nationally representative cross-sectional study from NHANES.","authors":"Linshan Pan, Yongjun Peng, Lihua Jiang","doi":"10.1016/j.jstrokecerebrovasdis.2024.108165","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108165","url":null,"abstract":"<p><strong>Background: </strong>The correlation between the prognostic nutritional index (PNI) and the risk of stroke has become a hot spot within the medical research community. The available evidence from a large sample regarding the correlation between PNI and stroke is inadequate. There is also a need for more research analysis from national surveys.</p><p><strong>Objective: </strong>The principal goal of this research is to improve our understanding of the relationship between PNI and the risk of stroke. This study also intends to investigate the potential synergistic influence of PNI on stroke in combination with other interacting variables.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with 35,549 participants selected from the National Health and Nutrition Examination Survey (NHANES) 2005-2018 cycle. Information was gathered from all participants regarding the following: lymphocyte count, albumin levels, stroke occurrence, age, sex, race/ethnicity, education level, poverty income ratio (PIR), marital status, body mass index (BMI), smoking habits, drinking status, physical activity measured in total metabolic equivalents (PA_total_MET), diabetes status, glycohemoglobin levels, total cholesterol, direct high-density lipoprotein cholesterol(direct HDL-cholesterol), hypertension, and coronary heart disease. Curve fitting, subgroup analysis, and multifactor weighted logistic regression analysis were used to examine the relationship between PNI and stroke.</p><p><strong>Results: </strong>The overall prevalence of stroke was found to be 3.9%, PNI quartile 4(Q4) had an increased prevalence of stroke than quartile 1, 2, and 3(Q1,2,3). Our research suggested a negative association between PNI and the risk of stroke, as indicated by the odds ratio (OR=0.98) with a 95% confidence interval (CI=0.97∼0.99) and a p-value <0.05 (P=0.005), even after adjusting for all confounders. Subsequent subgroup analysis indicated a significant difference in the impact of PNI on stroke between individuals with different body mass index(BMI) levels (p for interaction = 0.02).</p><p><strong>Conclusion: </strong>Our findings underscore that lower PNI in US adults is associated with an increased stroke risk, shedding light on a potential interrelationship between nutrition, inflammatory parameters, and stroke.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108165"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774904","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":"Cross-sectional analysis of non-HDL/HDL cholesterol ratio as a marker for cardiovascular disease risk in middle-aged and older adults: Evidence from the CHARLS study.","authors":"Changxing Liu, Zhirui Zhang, Tianwei Meng, Chengjia Li, Boyu Wang, Xulong Zhang","doi":"10.1016/j.jstrokecerebrovasdis.2024.108168","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108168","url":null,"abstract":"<p><strong>Background: </strong>While cardiovascular disease is linked to abnormal lipid metabolism, the relationship between NHHR (non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio), a new lipid metric, and cardiovascular disease in middle-aged and older adults in China is still unclear.</p><p><strong>Methods: </strong>This cohort study, based on a population sample, examined the incidence of cardiovascular disease (CVD) events, including stroke and heart disease. It utilized self-reported diagnoses from the study's inception and during Wave 4, involving 9259 participants from the China Health and Retirement Longitudinal Study (CHARLS). The research employed restricted cubic spline models and multivariate logistic regression to investigate possible non-linear relationships. Additionally, subgroup analyses were conducted to assess the influence of socio-demographic factors on the outcomes.</p><p><strong>Result: </strong>During the seven-year follow-up period, 1,139 participants developed CVD, including 742 cases of heart problems and 582 strokes. In Model 3, it was observed that for each unit increase in the highest NHHR group, the risk of developing CVD increased by 98%, the risk of stroke increased by 48%, and the risk of heart problems increased by 115%. Subgroup analyses indicated that this correlation was more pronounced among individuals under 60 years of age and those with hypertension.</p><p><strong>Conclusions: </strong>According to the current study, elevated NHHR ratio is an important risk factor for CVD in middle-aged and elderly Chinese. Early intervention in patients with higher NHHR ratios may help to further reduce the incidence of CVD.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108168"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781247","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}