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Prognostic value of urine dipstick proteinuria on mortality after acute ischemic stroke

 Jinkwon Kim  ;  Tae-Jin Song  ;  Dongbeom Song  ;  Joonsang Yoo  ;  Jang-Hyun Baek  ;  Chung Mo Nam  ;  , Hye Sun Lee  ;  Hyo Suk Nam  ;  Young Dae Kim  ;  Ji Hoe Heo 
 ATHEROSCLEROSIS, Vol.253 : 118-123, 2016 
Journal Title
Issue Date
Aged ; Aged, 80 and over ; Area Under Curve ; Biomarkers/urine ; Brain Ischemia/mortality* ; Brain Ischemia/urine* ; Cardiovascular Diseases/complications ; Data Interpretation, Statistical ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Patient Admission ; Predictive Value of Tests ; Proportional Hazards Models ; Prospective Studies ; Proteinuria/diagnosis* ; Reproducibility of Results ; Risk Factors ; Stroke/mortality* ; Stroke/urine*
Chronic Kidney Disease ; Ischemic stroke ; Mortality ; Proteinuria
BACKGROUND AND AIMS: Proteinuria is a marker of kidney disease and a strong risk factor for cardiovascular diseases including stroke. This study was aimed at investigating the prognostic value of proteinuria measured by urine dipstick in patients with acute ischemic stroke.

METHODS: This post-hoc analysis of a prospective cohort study included 3404 consecutive patients who had been admitted for acute ischemic stroke between November 2005 and June 2013. Proteinuria was defined as a trace or more of protein on a urine dipstick test routinely performed at admission. Date and cause of death until December 31, 2013 were collected. We investigated the association of proteinuria with all-cause mortality, cardiovascular mortality (defined as ICD-10 codes I00-I99), and non-cardiovascular mortality.

RESULTS: Proteinuria was present in 12.8% of the 3404 patients. During the mean follow-up period of 3.56 ± 2.22 years, there were 681 cases of all-cause mortality (460 cardiovascular deaths and 221 non-cardiovascular deaths). Multivariate Cox regression analysis showed that the presence of proteinuria was an independent risk factor for all-cause mortality (adjusted hazard ratio [HR] 1.69, 95% confidence interval [CI] 1.40-2.04), cardiovascular mortality (adjusted HR 1.65, 95% CI 1.31-2.08), and non-cardiovascular mortality (adjusted HR 1.59, 95% CI 1.13-2.23). Adding proteinuria to the multivariate Cox models moderately improved the model performance for all-cause mortality (integrated area under curve [95% CI]: from 0.800 [0.784-0.816] to 0.803 [0.788-0.818], p = 0.026).

CONCLUSIONS: Proteinuria, which was detected on a urine dipstick test, was a significant predictor of mortality after acute ischemic stroke.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kim, Young Dae(김영대) ORCID logo https://orcid.org/0000-0001-5750-2616
Nam, Chung Mo(남정모) ORCID logo https://orcid.org/0000-0003-0985-0928
Nam, Hyo Suk(남효석) ORCID logo https://orcid.org/0000-0002-4415-3995
Baek, Jang Hyun(백장현)
Song, Dong Beom(송동범)
Yoo, Joon Sang(유준상) ORCID logo https://orcid.org/0000-0003-1169-6798
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Heo, Ji Hoe(허지회) ORCID logo https://orcid.org/0000-0001-9898-3321
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