In-hospital medical complications associated with patient dependency after acute ischemic stroke: data from the China National Stroke Registry / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The mortality of stroke patients is strongly affected by medical complications. However, there are limited data investigating the effect of in-hospital medical complications on the dependency of stroke patients worldwide. We prospectively and systematically investigated the effect of medical complications on dependency of patients at 3, 6 and 12 months after stroke using the China National Stroke Registry (CNSR).</p><p><b>METHODS</b>This prospective cohort study collected data of patients age > 18 years with acute ischemic stroke in 132 clinical centers distributed across 32 provinces and four municipalities (including Hong Kong region) of China, from September 2007 to August 2008. Data on medical complications, dependency and other information were obtained from paper-based registry forms. Medical complications associated with stroke outcomes were assessed using multivariable Logistic regression.</p><p><b>RESULTS</b>Of 11 560 patients with acute ischemic stroke, 1826 (15.80%) presented with in-hospital medical complications. In-hospital medical complications were independent risk factors for dependency of patients at 3 months (adjusted odds ratio (OR) 2.367, 95% confidence interval (CI) 2.021 - 2.771), 6 months (adjusted OR 2.257, 95%CI 1.922 - 2.650), and 12 months (adjusted OR 1.820, 95%CI 1.538 - 2.154) after acute ischemic stroke.</p><p><b>CONCLUSION</b>The results demonstrated that the short-term and long-term dependency of acute ischemic stroke patients is significantly associated with in-hospital medical complications in China.</p>

Correlativity between single nucleotide polymorphisms in ALOX5AP promoter gene and ischemic stroke in north Chinese Han population / 中华神经科杂志

Objective To investigate the role of single nucleotide polymorphisms(SNPs)of ALOXSAP promoter gene in ischemic stroke susceptibility in north Chinese Han population.Methods A total of 220 ischemic stroke patients of north Chinese Han population and 191 healthy controls that had been matched for age and sex were enrolled in this study.Polymerase chain reaction(PCR)and direct sequencing were used for target gene genotyping and SNPs analysis.Association study was performed to analyze the relationship between genotype and phenotype and logistic regression was adopted to adjust the bias of conventional stroke risk factors.Results Three novel SNPs located in the promoter of ALOXSAP gene were found and frequencies of G/A genotype of-499 site, G/T genotype of-290 site and G/G genotype of -190 site were significantly higher in ischemic stroke patients than controls.Meanwhile, three haplotypes consisted of these SNPs were identified to be correlated with ischemic stroke, including a protective haplotype, Hap I(OR O.54, 95% CI 0.408 to 0.715), and two risk ones, Hap Ⅱ(OR 2.91, 95% CI 1.351 to 6.239)and Hap Ⅲ(OR 18.82, 95% CI 2.562 to 138.38).Meanwhile, the frequencies of G/A genotype of-499 site, G/T genotype of-290 site, Hap Ⅱ and Hap Ⅲ were significantly higher in ischemic stroke patients with more severe cerebral atherosclerosis indicated by digital subtract angiography. Conclusion Three novel SNPs in promoter of ALOX5AP gene are closely associated with ischemic stroke susceptibility in north Chinese Han population.