Levels and dynamics of estimated glomerular filtration rate and recurrent vascular events and death in patients with minor stroke or transient ischemic attack.


Journal

European journal of neurology
ISSN: 1468-1331
Titre abrégé: Eur J Neurol
Pays: England
ID NLM: 9506311

Informations de publication

Date de publication:
Sep 2022
Historique:
received: 17 05 2022
accepted: 23 05 2022
pubmed: 3 6 2022
medline: 9 8 2022
entrez: 2 6 2022
Statut: ppublish

Résumé

Impaired kidney function is associated with an increased risk of vascular events in acute stroke patients, when assessed by single measurements of estimated glomerular filtration rate (eGFR). It is unknown whether repeated measurements provide additional information for risk prediction. The MonDAFIS (Systematic Monitoring for Detection of Atrial Fibrillation in Patients with Acute Ischemic Stroke) study randomly assigned 3465 acute ischemic stroke patients to either standard procedures or an additive Holter electrocardiogram. Baseline eGFR (CKD-EPI formula) were dichotomized into values of < versus ≥60 ml/min/1.73 m Estimated glomerular filtration rate at baseline was available in 2947 and a second value in 1623 patients. After adjusting for age, stroke severity, cardiovascular risk factors, and randomization, eGFR < 60 ml/min/1.73 m In addition to patients with low eGFR levels at baseline, also those with decreasing eGFR have increased risk for vascular events and death; hence, repeated estimates of eGFR might add relevant information to risk prediction.

Sections du résumé

BACKGROUND AND PURPOSE
Impaired kidney function is associated with an increased risk of vascular events in acute stroke patients, when assessed by single measurements of estimated glomerular filtration rate (eGFR). It is unknown whether repeated measurements provide additional information for risk prediction.
METHODS
The MonDAFIS (Systematic Monitoring for Detection of Atrial Fibrillation in Patients with Acute Ischemic Stroke) study randomly assigned 3465 acute ischemic stroke patients to either standard procedures or an additive Holter electrocardiogram. Baseline eGFR (CKD-EPI formula) were dichotomized into values of < versus ≥60 ml/min/1.73 m
RESULTS
Estimated glomerular filtration rate at baseline was available in 2947 and a second value in 1623 patients. After adjusting for age, stroke severity, cardiovascular risk factors, and randomization, eGFR < 60 ml/min/1.73 m
CONCLUSIONS
In addition to patients with low eGFR levels at baseline, also those with decreasing eGFR have increased risk for vascular events and death; hence, repeated estimates of eGFR might add relevant information to risk prediction.

Identifiants

pubmed: 35652747
doi: 10.1111/ene.15431
doi:

Types de publication

Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2716-2724

Informations de copyright

© 2022 The Authors. European Journal of Neurology published by John Wiley &amp; Sons Ltd on behalf of European Academy of Neurology.

Auteurs

Serdar Tütüncü (S)

Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Berlin, Germany.

Manuel C Olma (MC)

Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Department of Neurology with Experimental Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.

Claudia Kunze (C)

Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Berlin, Germany.

Michael Krämer (M)

Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Berlin Institute of Health, Berlin, Germany.

Joanna Dietzel (J)

Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Berlin, Germany.

Johannes Schurig (J)

Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Berlin, Germany.

Paula Filser (P)

Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Berlin, Germany.

Waltraud Pfeilschifter (W)

Department of Neurology, University Hospital Frankfurt, Frankfurt am Main, Germany.

Gerhard F Hamann (GF)

Department of Neurology, BKH Günzburg, Günzburg, Germany.

Thomas Büttner (T)

Department of Neurology, Hans-Susemihl Hospital, Emden, Germany.

Peter U Heuschmann (PU)

Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany.
Comprehensive Heart Failure Center and Clinical Trial Center Würzburg, University Hospital Würzburg, Würzburg, Germany.

Paulus Kirchhof (P)

German Atrial Fibrillation Network, Münster, Germany.
Institute of Cardiovascular Sciences, College of Medical and Dental Sciences, Medical School, University of Birmingham, Birmingham, UK.
Departments of Cardiology, UHB and SWBH National Health Service Trusts, Birmingham, UK.
University Heart and Vascular Center Hamburg, Hamburg, Germany.

Ulrich Laufs (U)

Department of Cardiology, University Hospital of Leipzi, Leipzig, Germany.

Darius G Nabavi (DG)

Department of Neurology, Vivantes Hospital Neukölln, Berlin, Germany.

Joachim Röther (J)

Department of Neurology, Asklepios Clinic Altona, Hamburg, Germany.

Götz Thomalla (G)

Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Roland Veltkamp (R)

Department of Neurology, Alfried Krupp Hospital, Essen, Germany.
Department of Brain Sciences, Imperial College London, London, UK.

Kai-Uwe Eckardt (KU)

Department of Nephrology and Medical Intensive Care, Charité-Universitätsmedizin Berlin, Berlin, Germany.

Karl Georg Haeusler (KG)

Department of Neurology, University Hospital Würzburg, Würzburg, Germany.

Matthias Endres (M)

Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Department of Neurology with Experimental Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Berlin Institute of Health, Berlin, Germany.
German Center for Neurodegenerative Diseases, Partner Site Berlin, Berlin, Germany.
German Center for Cardiovascular Diseases, Partner Site Berlin, Berlin, Germany.
Excellence Cluster NeuroCure, Berlin, Germany.

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