Context: The causal association and biological mechanism linking serum 25-hydroxyvitamin D to stroke risk lacks epidemiological evidence.
Objective: This study aimed to investigate the association between 25(OH)D concentration and stroke risk as well as the potential mediating factors.
Design: The community-based prospective community-based cohort study, the Chin-Shan Community Cardiovascular Cohort, was conducted from 1990 to December 2011, with external validation using a two-sample Mendelian randomization (MR) study.
Patients: A total of 1,778 participants with serum 25-hydroxyvitamin D data were enrolled.
Methods: In the CCCC observational study, the outcome was ascertained as stroke, while in the two-sample MR study, it was defined as ischemic stroke. Causal effects were estimated using restricted cubic spline analysis, COX proportional hazard ratios, mediation analysis, and two-sample MR.
Results: Over 12 years (21,598 person-years) of follow-up, 163 participants (9.17%) developed stroke. Higher 25(OH)D concentrations were associated with lower stroke risk (hazard ratio: 0.64; 95% confidence interval, 0.43-0.96) after full-model adjustments. Mediation analysis showed a significant association between 25(OH)D concentration and stroke risk mediated by hypertension in unadjusted models (mediation percentage 23.3%, p=0.008) that became non-significant in full models (mediation percentage, 15.5%; p=0.072). Two-sample MR confirmed a significant inverse association between genetically determined 25(OH)D and stroke risk (IVW OR: 0.92; 95% CI: 0.85-0.99; p=0.036). However, hypertension had an insignificant mediating role in the Mendelian randomization study.
Conclusions: Higher 25(OH)D levels are linked to reduced stroke risk, potentially mediated by hypertension. Prioritizing blood pressure management may improve stroke prevention in 25(OH)D-deficient patients.
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http://dx.doi.org/10.1210/clinem/dgae561 | DOI Listing |
JAMA Surg
January 2025
Population Health Research Institute, Hamilton, Ontario, Canada.
Importance: Perioperative bleeding is common in general surgery. The POISE-3 (Perioperative Ischemic Evaluation-3) trial demonstrated efficacy of prophylactic tranexamic acid (TXA) compared with placebo in preventing major bleeding without increasing vascular outcomes in noncardiac surgery.
Objective: To determine the safety and efficacy of prophylactic TXA, specifically in general surgery.
Acta Neurol Belg
January 2025
Department of Neurology, CHU Nîmes, Hôpital Carémeau, Univ. Montpellier, Rue du Pr Debré, Nîmes, 30900, France.
Introduction: Radiological calcified cerebral embolism (CCE) characteristics have been reported in small case series. Our aim was to describe clinical and radiological CCE characteristics in a large number of CCE and to compare characteristics between different patient groups.
Methods: Characteristics of 79 stroke patients with CCE were analyzed retrospectively.
Curr Cardiol Rep
January 2025
Department of Medical Imaging, Montreal Heart Institute, Montréal, Québec, Canada.
Purpose Of Review: This review aims to explore the clinical significance of atrial fluorodeoxyglucose (FDG) uptake observed in positron emission tomography (PET) scans, focusing on its association with atrial fibrillation (AF), cardiac sarcoidosis, and myocarditis. We discuss the implications of atrial uptake for patient management and prognosis.
Recent Findings: Recent studies have demonstrated that atrial FDG uptake is frequently present in patients with AF, particularly those with persistent AF, and is linked to increased risks of stroke and poorer outcomes after ablation.
Eur Radiol Exp
January 2025
Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Background: Hemorrhagic transformation (HT) is a complication of reperfusion therapy following acute ischemic stroke (AIS). We aimed to develop and validate a model for predicting HT and its subtypes with poor prognosis-parenchymal hemorrhage (PH), including PH-1 (hematoma within infarcted tissue, occupying < 30%) and PH-2 (hematoma occupying ≥ 30% of the infarcted tissue)-in AIS patients following intravenous thrombolysis (IVT) based on noncontrast computed tomography (NCCT) and clinical data.
Methods: In this six-center retrospective study, clinical and imaging data from 445 consecutive IVT-treated AIS patients were collected (01/2018-06/2023).
J Endovasc Ther
January 2025
Aortic Center, Hôpital Marie-Lannelongue, Groupe Hospitalier Paris Saint Joseph, Université Paris-Saclay, INSERM UMR_S 999, Le Plessis Robinson, France.
Introduction: Management of patients with large aortic arch aneurysms who are considered high risk for frozen elephant trunk technique have been challenging, especially when they have a dilated ascending aorta (AA) that precludes total endovascular branched repair (arch BEVAR). A viable option in our armamentarium is wrapping of the AA (AW), and zone 0 Ishimaru TEVAR.
Methods: Retrospective analysis of our aortic database from 2013 to 2024 to select high-risk patients with aortic arch aneurysm that had an AW and TEVAR.
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