[inventory] selected articles of stroke in February 2020

< br / > < br / >< br / > < br / > researchers collected data on patients with acute or transient ischemic stroke from the Korean multicenter stroke registry databaseAccording to age, presence or absence of cerebral artery stenosis, stroke severity and stroke subtype, the correlation between hemoglobin concentration and one-year stroke recurrence and complex vascular events was evaluatedThe level of hemoglobin was negatively correlated with the recurrence of stroke and complex vascular eventsThe incidence of stroke recurrence and complex vascular events was significantly higher in patients with anemia or moderate anemia within one yearIn multivariate analysis, moderate anemia was still an independent predictor of stroke recurrence (adjusted risk ratio, 1.43 [95% CI, 1.16-1.55]) and composite vascular events (adjusted risk ratio, 1.26 [95% CI, 1.07-1.48])Moderate anemia increased the risk of composite vascular events in patients with moderate to severe stroke (NIH Stroke Scale score < 16, interaction P = 0.01)It can be seen that hemoglobin concentration may be an independent predictor of stroke recurrence and complex vascular eventshttps：//article.do ? Id = 35fc18e90448 < br / > < br / > stroke: compared with other ischemic stroke, the pathogenesis of ESUs is still unclearPrevious literature suggests that ESUs may be due to the absence of detection of cardiogenic embolismRecently, a research article was published in stroke, an authoritative journal in the field of cardiovascular diseasesThis research aims to improve the understanding of the pathophysiology of ESUs through the current knowledge of sleep disordersPatients with ischemic stroke who completed polysomnography or home sleep apnea were included in this studyThe researchers classified stroke as one of six mechanisms and compared it with sleep disorders (i.e., obstructive sleep apnea, periodic limb movements, and sleep structural abnormalities)compared with other stroke mechanisms, there was a significant correlation between OSA and the stroke mechanism of cardiac embolism (P=0.018)There was no significant correlation between obstructive sleep apnea and ESUs (P = 0.585) Compared with other stroke patients, ESUs patients were more likely to have higher periodic limb activity index (P = 0.037) and longer sleep attack latency (P = 0.0166) < br / > < br / > it can be seen that ESUs has nothing to do with the markers of cardiac embolism stroke (such as obstructive sleep apnea) There is a significant relationship between ESUs and the increase of periodic limb activity and the damage of sleep structure, which indicates that there may be multiple factors underlying pathophysiological mechanism in ESUs https：// article.do ? Id = 976218e905b4 < br / > < br / > stroke: diastolic pressure can affect the local white matter damage load < br / > < br / > there have been few previous studies to detect the single impact of SBP and DBP on cerebrovascular disease After the issuance of 2017 edition of the American Society of Cardiology / American Heart Association blood pressure guidelines, this defect has become more prominent In addition, the relationship between blood pressure and wmhv has not been fully studied Recently, a study published in the journal stroke described this The < br / > < br / > study is based on data from the North Manhattan Study (NOMAS), a prospective cohort study of the association between stroke risk and cognitive decline The researchers analyzed the correlation between SBP and DBP (as defined in the 2017 American College of Cardiology / American Heart Association guidelines) and regional wmhv, using a linear hybrid model to explain the relevant properties of regional wmhv < br / > There was significant difference between DBP level and wmhv in different regions (P < 0.05) And DBP > 90 mm? Compared with patients with Hg, wmhv decreased by 13% (95% CI: - 21% ~ - 3%) in frontal lobe, 11% (95% CI: - 19% ~ - 1%) in parietal lobe, 22% (95% CI: - 30% ~ - 14%) in anterior periventricular area and 16% (95% CI: - 24% ~ - 6%) in posterior periventricular area And DBP ≥ 90 mm? The DBP was 80-89 mm? In Hg group, wmhv decreased by 12% (95% CI: - 20% ～ - 3%) in the anterior periventricular area and 9% (95% CI: - 18% ～ - 0.4%) in the posterior periventricular area Post paired t-test showed that there was a significant difference between the estimated value of periventricular wmhv and temporal wmhv (corrected P < 0.05) In addition, there was no significant correlation between SBP and regional wmhv < br / > < br / > according to the definition defined in the 2017 edition of the American College of Cardiology / American Heart Association guidelines, low DBP levels are associated with a lower load of white matter lesions, particularly in the periventricular region https：// article.do ? Id = 21e418e91999 < br / > < br / > stroke: carotid intima thickness increases, and the risk of first stroke is higher < br / > < br / > carotid intima thickening is the vascular wall hyperplasia caused by atherosclerosis, the main consequences are cerebral blood supply deficiency and cerebrovascular disease Recently, stroke magazine published the research results of Professor Huo Yong's team from the first hospital of Peking University, which aims to explore the relationship between the average carotid intima-media thickness (CIMT) and the risk of first stroke in patients with hypertension, and explore any potential influencing factors < br / > < br / > there are 11? 547 hypertension patients without stroke history participated in the first level stroke prevention trial in China The main end point of the trial was the first stroke During the median follow-up of 4.4 years, 726 cases of first stroke occurred, 631 of them were ischemic stroke and 90 were hemorrhagic stroke The risk of first stroke (HR = 1.11; 95% CI: 1.03-1.20) and first ischemic stroke (HR = 1.10; 95% CI: 1.01-1.20) increased with each SD increase of average CIMT, and there was a positive correlation In addition, patients in quartile 2-4 (> 0.66 mm) had a higher risk of first stroke (HR = 1.31; 95% CI: 1.06-1.61) and first hemorrhagic stroke (HR = 2.25; 95% CI: 1.11-4.58) when CIMT was divided into quartile More importantly, at mean arterial pressure [≥ 109.3 (quintile 5) vs < 109.3 mm? Hg, P interaction = 0.024] or DBP level [≥ 90.7 (quintile 5) vs < 90.7 mm? In patients with high Hg, P interaction = 0.009], the correlation between CIMT and the risk of first stroke was significantly increased The results of this study suggest that there is a significant positive correlation between baseline CIMT and the risk of first stroke in patients with hypertension At the same time, the correlation was stronger in the group with higher mean arterial pressure or diastolic pressure https：// article.do ? Id = 770c18801803 < br / > Stroke related brain damage leads to autonomic dysfunction and inflammation, sometimes leading to heart complications Previous studies focused on the gender differences of mace after stroke but did not exclude the patients with known cardiovascular complications Therefore, gender specific cardiovascular susceptibility of stroke and no mixed effects of cardiovascular diseases are an area to be studied Recently, Stroke magazine published a study in a cohort of patients without cardiovascular disease to investigate the gender specific risk of MACE in patients with first ischemic stroke and those with tendency to match stroke < br / > The researchers investigated the 1-year risk of mace (acute coronary syndrome, myocardial infarction, coronary heart disease, coronary revascularization, heart failure, or cardiovascular death) in women and men, respectively In order to estimate the adjusted hazard ratio (AHR) for a specific cause, the variables with weighted SD > 0.10 or known variables that can affect mace risk were adjusted and analyzed using Cox model < br / > < br / > 93? 627 subjects without known cardiovascular complications, 21? 931 patients with first ischemic stroke and 71? 696 subjects without stroke had a good balance of tendency matching variables 53? 476 women (12? 421 cases of ischemic stroke, 41? 055 cases without ischemic stroke) and 40? 151 males (9510 ischemic stroke, 30? 641 cases had no ischemic stroke The first ischemic stroke attack was associated with an increased risk of mace in men and women, which was time-dependent and was the highest in 30 days (female: AHR = 25.1; 95% CI: 19.3-32.6; male: AHR = 23.4; 95% CI: 17.2-31.9), but decreased significantly in 31-90 days (female: AHR = 4.8; 95% CI: 3.8-6.0; male: AHR = 4.2; 95% CI: 3.3-5.4), 91 days to 365 days (AHR = 2.1; 95% CI: 1.8-2.3; male: AHR = 2.0; 95% CI: 1.7-2.3) < br / > < br / > the results of this large population study showed that the first ischemic stroke attack was independently associated with an increased risk of mace in patients of different genders https：// article.do ? Id = 6eb5188019f1 < br / > < br / > stroke: the level of circulating neutral hormone binding globulin (SHBG) was negatively correlated with obesity, diabetes and other heart metabolic diseases It is not clear whether low SHBG predicts stroke risk, especially in women Recently, a research article was published in stroke, an authoritative journal in the field of cardiovascular diseases Researchers investigated whether SHBG of women in the women's Health Initiative (WHI) project is related to the risk of ischemic stroke (is) From 1993 to 1998, 161808 postmenopausal women from 40 regions in the United States participated in the WHI 13192 participants without stroke at baseline were selected and their serum SHBG levels were measured The researchers used Cox proportional risk regression (stratified by SHBG measurement analysis) to assess the is risk at the quintile level of SHBG (Q1-Q5), first adjusted for demographic variables (model 1), then adjusted for body mass index, hypertension, drinking and smoking status (model 2), as well as physical activity and reproductive risk factors (model 3) In sensitivity analysis, potential mediators (diabetes status, estradiol, testosterone, and CRP [C-reactive protein] levels) were included < br / > < br / > after an average follow-up of 11.6 years, 13192 participants (average age 62.5 years; non Hispanic white 67.4%, non Hispanic white 18.5%, Hispanic 7.6% and Asian 5.0%) were adjudicated and 768 is events were adjudicated Compared with the highest quintile of SHBG (Reference), women in the lowest quintile of SHBG had higher is risk in all three multivariate models (model 1: 1.88 [95% CI: 1.47-2.41]; model 2: 1.69 [95% CI: 1.30-2.20]; model 3: 1.61 [95% CI: 1.19-2.19]; trend test: P < 0.05).