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  • BMJ  (3)
  • Xu, Jie  (3)
  • English  (3)
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  • BMJ  (3)
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  • English  (3)
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  • 1
    Online Resource
    Online Resource
    Low LDL-C level and intracranial haemorrhage risk after ischaemic stroke: a prospective cohort study
    BMJ ; 2023
    In:  Stroke and Vascular Neurology Vol. 8, No. 2 ( 2023-04), p. 127-133
    Details
    In: Stroke and Vascular Neurology, BMJ, Vol. 8, No. 2 ( 2023-04), p. 127-133
    Abstract: The Treat Stroke to Target trial has confirmed the benefit of targeting low-density lipoprotein cholesterol (LDL-C) of 〈 1.8 mmol/L in patients who had an ischaemic stroke (IS). However, haemorrhagic risk brought by this target level ( 〈 1.8 mmol/L) or even lower level ( 〈 1.4 mmol/L) of LDL-C should also be concerned. In this study, we aimed to demonstrate whether low LDL-C could increase the intracranial haemorrhage risk following IS. Methods Patients who had an IS from China Stroke Center Alliance programme with complete baseline information were prospectively enrolled. 793 572 patients who had an IS were categorised into 6 groups according to LDL-C level ( 〈 1.40 mmol/L, 1.40–1.79 mmol/L, 1.80–2.59 mmol/L, 2.60–2.99 mmol/L, 3.00–4.89 mmol/L, ≥4.90 mmol/L). The study outcome was defined as intracranial haemorrhage identified during hospitalisation. Logistic regression model was used to examine the association between different LDL-C levels and risk of intracranial haemorrhage. Results Compared with patients of LDL-C=1.80–2.59 mmol/L, both subgroups of LDL-C 〈 1.40 mmol/L and LDL-C=1.40–1.79 mmol/L showed significantly higher risk of intracranial haemorrhage (OR=1.26, 95% CI=1.18 to 1.35; OR=1.22, 95% CI=1.14 to 1.30, respectively). Interaction effect was found to exist between the subgroups of intravenous thrombolytic therapy (p=0.04), rather than the subgroups of age, sex and body mass index. Moreover, the sensitivity analyses indicated that even patients who had an IS with minor stroke still suffered from the increased intracranial haemorrhage risk related to low LDL-C level. Conclusions Among patients who had an IS, the low LDL-C level ( 〈 1.4 mmol/L or 〈 1.8 mmol/L) at baseline is associated with increased risk of intracranial haemorrhage during acute stage. While actively lowering LDL-C level for patients who had an IS, clinicians should also concern about the haemorrhagic risk associated with low LDL-C level.
    Type of Medium: Online Resource
    ISSN: 2059-8688 , 2059-8696
    URL: Article
    DOI: 10.1136/svn-2022-001612
    Language: English
    Publisher: BMJ
    Publication Date: 2023
    detail.hit.zdb_id: 2847692-X
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  • 2
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    Different contribution of SBP and DBP variability to vascular events in patients with stroke
    BMJ ; 2020
    In:  Stroke and Vascular Neurology Vol. 5, No. 2 ( 2020-06), p. 110-115
    Details
    In: Stroke and Vascular Neurology, BMJ, Vol. 5, No. 2 ( 2020-06), p. 110-115
    Abstract: High blood pressure variability (BPV) is a novel risk factor for cardiovascular disease. However, the heterogeneity of systolic blood pressure variability (SBPV) and diastolic blood pressure variability (DBPV) for different vascular events remains unclear. This study aims to investigate whether SBPV or DBPV has different contribution to vascular events in patients with acute ischaemic stroke (IS) or transient ischaemic attack (TIA). Methods Data from the BOSS (blood pressure and clinical outcome in TIA or IS) study were examined for vascular events at 3-month and 1-year follow-up. BPV was defined as the SD and coefficient of variation (CV) of day-to-day measurements within 3 months after IS/TIA. Vascular events include cardiovascular events (myocardial infarction, unstable angina, cardiac death and congestive heart failure) and cerebrovascular events (ischaemic or haemorrhagic stroke). Logistic regression model was used to test the associations between BPV and vascular events. Results Of 2325 patients with IS or TIA, 103 (4.43 %) experienced a recurrent stroke and 64 (2.75 %) had cardiovascular events within 3 months. Day-to-day SBPV was only associated with stroke recurrence (BPV SD : OR, 1.72, 95% CI 1.09 to 2.71; BPV CV : 1.86, 95% CI 1.19 to 2.92), but not cardiovascular events (BPV SD : 1.67, 95% CI 0.94 to 2.94; BPV CV : 1.51, 95% CI 0.86 to 2.64). However, DBPV seems to be related to both stroke (BPV SD : 1.60, 95% CI 1.02 to 2.49; BPV CV : 1.53, 95% CI 0.99 to 2.37) and cardiovascular events (BPV SD : 2.48, 95% CI 1.37 to 4.48; BPV CV : 1.92, 95% CI 1.09 to 3.36). Similar results were found at 1 year. Conclusions For patients with IS/TIA, stroke recurrence was associated with both SBPV and DBPV; however, cardiovascular events seem to be only related to DBPV.
    Type of Medium: Online Resource
    ISSN: 2059-8688 , 2059-8696
    URL: Article
    DOI: 10.1136/svn-2019-000278
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 2847692-X
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  • 3
    Online Resource
    Online Resource
    Cumulative burden of lipid profiles predict future incidence of ischaemic stroke and residual risk
    BMJ ; 2021
    In:  Stroke and Vascular Neurology Vol. 6, No. 4 ( 2021-12), p. 581-588
    Details
    In: Stroke and Vascular Neurology, BMJ, Vol. 6, No. 4 ( 2021-12), p. 581-588
    Abstract: Incident ischaemic stroke (IS) risk may increase not only with lipids concentration but also with longer duration of exposure. This study aimed to investigate the impact of cumulative burden of lipid profiles on risk of incident IS. Methods A total of 43 836 participants were enrolled who participated in four surveys during 2006–2013. Individual cumulative lipid burden was calculated as number of years (2006–2013) multiplied by the levels of low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), non-HDL-C and triglyceride (TG), respectively. The primary outcome was defined as the incident IS during 2012–2017. Results During 4.67 years (±0.70 years) follow-up on average, we identified 1023 (2.33%) incident IS. Compared with respective reference groups, the HRs (95% CIs) of the upper tertile in cumulative TG burden, cumulative LDL-C burden, cumulative TC burden and cumulative non-HDL-C burden were 1.26 mmol/L (1.02–1.55 mmol/L), 1.47 mmol/L (1.25–1.73 mmol/L), 1.33 mmol/L (1.12–1.57 mmol/L) and 1.51 mmol/L (1.28–1.80 mmol/L) for incidence of IS, respectively. However, this association was not significant in cumulative HDL-C burden and IS (HR: 1.09; 95% CI: 0.79 to 1.52), after adjustment for confounding variables. Among 16 600 participants with low cumulative LDL-C burden, HRs (95% CI) for TC, TG, non-HDL-C and HDL-C with IS were 1.63 mmol/L (1.03–2.57 mmol/L), 1.65 mmol/L (1.19–2.31 mmol/L), 1.57 mmol/L (1.06–2.32 mmol/L) and 0.98 mmol/L (0.56–1.72 mmol/L), respectively. Conclusions We observed the correlation between cumulative burden of lipid profiles, except for cumulative burden of HDL-C, with the risk of incident IS. Cumulative burden of TC, TG and non-HDL-C may still predict IS in patients with low cumulative LDL-C burden. Trial registration number ChiCTR-TNRC-11001489.
    Type of Medium: Online Resource
    ISSN: 2059-8688 , 2059-8696
    URL: Article
    DOI: 10.1136/svn-2020-000726
    Language: English
    Publisher: BMJ
    Publication Date: 2021
    detail.hit.zdb_id: 2847692-X
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