Serum Phosphate and 1-Year Outcome in Patients With Acute Ischemic Stroke and Transient Ischemic Attack.

Abstract

Objective: To determine the association between serum phosphate level and 1-year clinical outcomes in patients with acute ischemic stroke and transient ischemic attack. Methods: We included 7,353 patients with acute ischemic stroke and transient ischemic attack from the China National Stroke Registry III for analysis. Participants were divided into 4 groups according to serum phosphate quartiles. Composite end point included recurrent stroke, myocardial infarction, other ischemic vascular events, and all-cause mortality. Poor functional outcome is defined as modified Rankin Scale score of 3 to 6. Multivariable Cox regression or logistic regression was used to evaluate the independent association of serum phosphate with 1-year all-cause mortality, recurrent stroke, composite end point and poor functional outcome. Results: The mean age of the included 7,353 patients was 62.5 years, and 68.6% of them were men. Plotting hazard ratios over phosphate levels suggested a U-shaped association especially for recurrent stroke and composite end point, and therefore the third quartile group was set as reference group. Compared with the third quartile of phosphate (1.06-1.20 mmol/L), the adjusted hazard ratios/odds ratios (95% CI) of the lowest quartile (<0.94 mmol/L) were 0.98 (0.67-1.42) for all-cause mortality, 1.31 (1.05-1.64) for stroke recurrence, 1.26 (1.02-1.57) for composite end point, and 1.27 (1.01-1.61) for poor functional outcome, and the adjusted odds ratio of the highest quartile (≥1.2 mmol/L) was 1.40 (1.11-1.77) for poor functional outcome. Conclusions: Serum phosphate may be an independent predictor of stroke recurrence, composite end point and poor functional outcome after ischemic stroke.

• Authors: Jun-Fang Zhang, Jing Jing, Xia Meng, Yuesong Pan, Yi-Long Wang, Xing-Quan Zhao, Jin-Xi Lin, Xin-Sheng Han, Bin-Bin Song, Zheng-Chang Jia, Song-Di Wu, Xiao-Fei Chen, Wen-Jun Xue, Craig S Anderson, Yun-Cheng Wu, Yong-Jun Wang
• Journal: Frontiers in neurology (Front Neurol) Vol. 12 Pg. 652941 ( 2021) ISSN: 1664-2295 [Print] Switzerland
• PMID: 33935953 (Publication Type: Journal Article)
• Copyright: Copyright © 2021 Zhang, Jing, Meng, Pan, Wang, Zhao, Lin, Han, Song, Jia, Wu, Chen, Xue, Anderson, Wu and Wang.