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Atherosclerosis. 2016 Oct;253:118-123. doi: 10.1016/j.atherosclerosis.2016.08.030. Epub 2016 Aug 25.

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

Author information

1
Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology, Bundang CHA Medical Center, CHA University School of Medicine, Seongnam, South Korea.
2
Department of Neurology, Ewha Womans University, Seoul, South Korea.
3
Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.
4
Department of Biostatistics, Yonsei University College of Medicine, Seoul, South Korea.
5
Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea. Electronic address: jhheo@yuhs.ac.

Abstract

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.

KEYWORDS:

Chronic Kidney Disease; Ischemic stroke; Mortality; Proteinuria

[Indexed for MEDLINE]

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