ABSTRACT
OBJECTIVE: This study aimed to examine the relationship between total bilirubin levels and initial ischemic stroke in patients with non-valvular atrial fibrillation. METHODS: This was a retrospective study. Atrial fibrillation was diagnosed by 24-hour Holter electrocardiography and serum total bilirubin levels were divided into quintiles. Ischemic stroke was diagnosed by symptoms, signs, and a medical image examination. The multivariate Cox proportional hazards model and survival analysis were used to estimate the association of total bilirubin with initial ischemic stroke. RESULTS: We studied 316 patients with non-valvular atrial fibrillation. During follow-up, there were 42 (13.29%) first ischemic strokes. After multivariate adjustment, for each 1 µmol/L increase in total bilirubin, the risk of first ischemic stroke increased by 4% (95% confidence interval [CI]: 1.01, 1.07). When using the first quintile as the reference, from the second to fifth quintiles, the risks of first ischemic stroke were 0.52 (95% CI: 0.17, 1.65), 0.23 (95% CI: 0.06, 0.87), 0.92 (95% CI: 0.32, 2.67), and 1.33 (95% CI: 1.09, 4.41), respectively. The optimal cut-off point of total bilirubin for the lowest risk of ischemic stroke was 17.0 µmol/L. CONCLUSIONS: Total bilirubin levels are nonlinearly associated with initial ischemic stroke in patients with non-valvular atrial fibrillation.
Subject(s)
Atrial Fibrillation , Brain Ischemia , Ischemic Stroke , Stroke , Atrial Fibrillation/complications , Bilirubin , Brain Ischemia/complications , Brain Ischemia/diagnosis , Humans , Retrospective Studies , Risk FactorsABSTRACT
AIMS: To explore the association between platelet distribution width (PDW) and stroke in atrial fibrillation (AF) patients. METHODS: This study included 150 AF patients who were divided into stroke and non-stroke groups. Multivariate logistic regression analysis and area under the receiver operating characteristic curve were performed. RESULTS: Among the 150 patients, 50 and 100 were grouped into the stroke and non-stroke groups, respectively. There were significant differences in systolic blood pressure, total cholesterol, C-reactive protein, and PDW between the groups (P<0.05). Multiple logistic regression analysis showed that PDW (OR: 1.56, P=0.002) was a risk factor for stroke. CONCLUSIONS: PDW was an important risk factor for stroke in AF patients, suggesting it has the potential to be a new biomarker for predicting stroke.
Subject(s)
Atrial Fibrillation/complications , Blood Platelets/pathology , Mean Platelet Volume , Stroke/diagnosis , Adolescent , Adult , Aged , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Prognosis , ROC Curve , Risk Factors , Stroke/etiology , Young AdultABSTRACT
AIM: It has been found that serum total bilirubin has a vital role in anti-inflammatory and antioxidant progress. Prehypertension, the intermediate stage between normal blood pressure and hypertension, is linked with subclinical atherosclerosis and target-organ damage. METHODS: This study was designed to evaluate the relationship between total bilirubin and carotid intima-media thickness (cIMT), a marker of subclinical atherosclerosis, in patients with prehypertension. RESULTS: We consecutively enrolled 219 patients with prehypertension. All the participants were divided into two groups according to cIMT values (<0.9 vs. ≥0.9 mm). We found that the increased cIMT group has higher systolic blood pressure, triglyceride and C- reactive protein, but lower total bilirubin compared to the normal cIMT group. The cIMT was negatively correlated with total bilirubin. Multivariate regression analyses revealed total bilirubin was an independent factor for subclinical atherosclerosis. CONCLUSION: This study demonstrated that serum total bilirubin was inversely related with cIMT, and was an independent predictor of subclinical atherosclerosis in patients with prehypertension.
