Serum albumin level is associated with the recurrence of acute ischemic stroke

Zhang, Qing; Lei, Yi-Xiong; Wang, Qiang; Jin, Yongping; Fu, Rong-Li; Geng, He-Hong; Huang, Lingling; Wang, Xiaoxiao; Wang, Pei‐Xi

doi:10.1016/j.ajem.2016.06.049

Cited by 32 publications

(36 citation statements)

References 31 publications

(34 reference statements)

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“…Studies have shown that each of these indicators is a predictor of stroke prognosis [7,9,27,28]. Further, serum albumin and hemoglobin concentration have predictive value for stroke recurrence and combined events [11,12]. The new indicator HALP score is based on the combination of the four hematological parameters mentioned above.…”

Section: Discussionmentioning

confidence: 99%

“…Anemia and hypoalbuminemia are manifestations of poor nutritional status and have been identi ed as risk factors for cerebrovascular events that may lead to poor prognosis in patients with AIS [9,10]. Anemia and lower albumin levels at admission may adversely affect the prognosis of stroke and can be used as indicators for stroke recurrence [11,12].…”

Section: Introductionmentioning

confidence: 99%

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Hemoglobin, Albumin, Lymphocyte, and Platelet Score is Associated With Adverse Clinical Outcomes of Acute Ischemic Stroke: A Prospective Cohort Study

Tian

Wang

et al. 2020

Preprint

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Background The combined index of hemoglobin, albumin, lymphocyte and platelet (HALP) is considered as a novel score to reflect systemic inflammation and nutritional status. This study aimed to investigate the association between HALP score and adverse clinical events in patients with acute ischemic stroke (AIS). Methods This study prospectively included patients with AIS within 24 hours of admission to the First Affiliated Hospital of Zhengzhou University. The primary outcomes were all-cause death within 90 days and 1 year. The secondary outcomes included stroke recurrence and combined vascular events. The association between HALP score and adverse clinical outcomes was analyzed using Cox proportional hazards. Results A total of 1337 patients were included. Patients in the highest tertile of HALP score had a lower risk of death within 90 days and 1 year (Hazard ratio: 0.20 and 0.30; 95% confidence intervals: 0.06–0.66 and 0.13–0.69, P for trend < 0.01 for all) compared with the lowest tertile after adjusting relevant confounding factors. Similar results were found for secondary outcomes. Subgroup analyses further confirmed these association. Adding HALP score to the conventional risk factors improved prediction of death in patients with AIS within 90 days and 1 year (net reclassification index, 38.63% and 38.68%; integrated discrimination improvement, 2.43% and 2.57%; P < 0.02 for all). Conclusions High HALP score levels were associated with decreased risk of adverse clinical outcomes within 90 days and 1 year after stroke onset, suggesting that HALP score may serve as a powerful indicator for AIS.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Hemoglobin, Albumin, Lymphocyte, and Platelet Score is Associated With Adverse Clinical Outcomes of Acute Ischemic Stroke: A Prospective Cohort Study

Tian

Wang

et al. 2020

Preprint

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“…It can infer that moderate increase of hemoglobin may be bene cial to the prognosis of CVST patients. Serum albumin, the most abundant plasma protein, has many physiological properties, including anti-in ammatory, antioxidant and antiplatelet aggregation activity 20,21 . In a study that included 759 patients with acute ischemic stroke followed for 3 months, poor outcome was independently linked to low serum albumin level, ischemic heart disease and infarct size (P < 0.05 for all) 22 .…”

Section: Discussionmentioning

confidence: 99%

“…In a study that included 759 patients with acute ischemic stroke followed for 3 months, poor outcome was independently linked to low serum albumin level, ischemic heart disease and infarct size (P < 0.05 for all) 22 . Large amount of evidence demonstrated that hypoalbuminemia is a strong, independent prognostic factor in stroke or CVST [21][22][23][24] . Brain ischemia is followed by the activation of the immune system in a sterile in ammatory reaction, resulting in the change of cell adhesion molecules, cytokines, as well as in ltration of leukocytes in the ischemic tissue.…”

Section: Discussionmentioning

confidence: 99%

The Novel Biomarkers-Based HALP (Hemoglobin, Albumin, Lymphocyte and Platelet)-Prognostic Model for Acute and Subacute Patients with Cerebral Venous Sinus Thrombosis: A Retrospective Cohort Study

Shen

Gao

Zhao

et al. 2020

Preprint

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Background and purpose: To evaluate the prognosis values of HALP in acute or subacute cerebral venous sinus thrombosis (CVST), to explore the new prognostic model for CVST.Methods: Consecutive patients who were diagnosed as having acute and subacute CVST were retrospectively investigated. We determined the patients' functional outcomes by modified Rankin Scale (mRS). Multivariate logistic regression analysis was used to assess the relationship between factors and poor functional outcomes. The area under the ROC curve (AUC) was estimated to evaluate the ability of markers and models in predicting clinical prognosis. The prognostic model was presented as nomogram. In addition, the decision curve analysis (DCA) was used to analyze the benefit of this model. Furthermore, survival curves were described by the Kaplan‑Meier analysis. Results: A total of 270 patients were included of which 31 had poor outcome. Multivariable logistic regression analysis demonstrated HALP (OR=0.978, 95%CI: 0.958-0.999, P=0.039) was a protective predictor of outcome. The AUC of HALP was 0.749 (95% CI: 0.633-0.865, P=0.044). DCA demonstrated that this model significantly improved risk prediction at threshold probabilities of CVST at 0 to 85%. Patients with higher HALP (P=0.006) presented higher overall survival rates. Conclusions: HALP may be a potential protective marker in acute and subacute CVST patients. The new prognostic model with HALP had potentially better value for Chinese CVST patients.

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“…We prospectively and consecutively enrolled AIS patients (in the first week following onset of disease [12]). All ischemic stroke patients admitted to the Department of Neurology of West China Hospital, Sichuan University (Chengdu, China) from January 2012 to December 2016 were evaluated for eligibility.…”

Section: Study Populationmentioning

confidence: 99%

Serum Albumin Is Negatively Associated with Hemorrhagic Transformation in Acute Ischemic Stroke Patients

et al. 2019

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Background and Objective: Hemorrhagic transformation (HT) is a major complication of acute ischemic stroke (AIS). Serum albumin is known for its neuroprotective effects and is a marker of improved AIS patient outcomes. However, it is not known whether there is a relationship between serum albumin and HT. Methods: AIS patients admitted to the Department of Neurology of West China Hospital from 2012 to 2016 were prospectively and consecutively enrolled. Baseline characteristics were collected. HT during hospitalization was diagnosed by brain imaging. Multivariate logistic regression analysis was performed to determine the relationship between serum albumin and HT. Confounding factors were identified by univariate analysis. Stratified logistic regression analysis was performed to identify effect modifiers. Results: A total of 1996 AIS patients were recruited, of whom 135 (6.8%) developed HT. Serum albumin negatively correlated with HT. Patients in the upper serum albumin tertile (42.6–54.1 g/L) had a 46% lower risk of HT than patients in the lower tertile (19.3–39.1 g/L) after adjustment for potential confounders (OR 0.54, 95% CI 0.29–0.99, p = 0.04). Risk of HT decreased stepwise with higher serum albumin tertile (p for trend = 0.04). There was a significant interaction between serum albumin and age (p = 0.02), with no significant correlation between serum albumin and HT in patients over 60 years of age. Conclusions: Higher serum albumin is associated with lower HT risk in a dose-dependent manner in AIS patients younger than 60 years.

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Serum albumin level is associated with the recurrence of acute ischemic stroke

Cited by 32 publications

References 31 publications

Hemoglobin, Albumin, Lymphocyte, and Platelet Score is Associated With Adverse Clinical Outcomes of Acute Ischemic Stroke: A Prospective Cohort Study

Hemoglobin, Albumin, Lymphocyte, and Platelet Score is Associated With Adverse Clinical Outcomes of Acute Ischemic Stroke: A Prospective Cohort Study

The Novel Biomarkers-Based HALP (Hemoglobin, Albumin, Lymphocyte and Platelet)-Prognostic Model for Acute and Subacute Patients with Cerebral Venous Sinus Thrombosis: A Retrospective Cohort Study

Serum Albumin Is Negatively Associated with Hemorrhagic Transformation in Acute Ischemic Stroke Patients

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