Prognostic value of urine dipstick proteinuria on mortality after acute ischemic stroke

Jinkwon Kim, Tae Jin Song, Dongbeom Song, Joonsang Yoo, Jang Hyun Baek, Hye Sun Lee, Chung Mo Nam, Hyo Suk Nam, Young Dae Kim, Jihoe Heo

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background and aims Proteinuria is a marker of kidney disease and a strong risk factor for cardiovascular diseases including stroke. This study was aimed at investigating the prognostic value of proteinuria measured by urine dipstick in patients with acute ischemic stroke. Methods This post-hoc analysis of a prospective cohort study included 3404 consecutive patients who had been admitted for acute ischemic stroke between November 2005 and June 2013. Proteinuria was defined as a trace or more of protein on a urine dipstick test routinely performed at admission. Date and cause of death until December 31, 2013 were collected. We investigated the association of proteinuria with all-cause mortality, cardiovascular mortality (defined as ICD-10 codes I00–I99), and non-cardiovascular mortality. Results Proteinuria was present in 12.8% of the 3404 patients. During the mean follow-up period of 3.56 ± 2.22 years, there were 681 cases of all-cause mortality (460 cardiovascular deaths and 221 non-cardiovascular deaths). Multivariate Cox regression analysis showed that the presence of proteinuria was an independent risk factor for all-cause mortality (adjusted hazard ratio [HR] 1.69, 95% confidence interval [CI] 1.40–2.04), cardiovascular mortality (adjusted HR 1.65, 95% CI 1.31–2.08), and non-cardiovascular mortality (adjusted HR 1.59, 95% CI 1.13–2.23). Adding proteinuria to the multivariate Cox models moderately improved the model performance for all-cause mortality (integrated area under curve [95% CI]: from 0.800 [0.784–0.816] to 0.803 [0.788–0.818], p = 0.026). Conclusions Proteinuria, which was detected on a urine dipstick test, was a significant predictor of mortality after acute ischemic stroke.

Original languageEnglish
Pages (from-to)118-123
Number of pages6
JournalAtherosclerosis
Volume253
DOIs
Publication statusPublished - 2016 Oct 1

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Proteinuria
Stroke
Urine
Mortality
Confidence Intervals
International Classification of Diseases
Kidney Diseases
Proportional Hazards Models
Area Under Curve
Cause of Death
Cohort Studies
Cardiovascular Diseases
Regression Analysis
Prospective Studies

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Kim, Jinkwon ; Song, Tae Jin ; Song, Dongbeom ; Yoo, Joonsang ; Baek, Jang Hyun ; Lee, Hye Sun ; Nam, Chung Mo ; Nam, Hyo Suk ; Kim, Young Dae ; Heo, Jihoe. / Prognostic value of urine dipstick proteinuria on mortality after acute ischemic stroke. In: Atherosclerosis. 2016 ; Vol. 253. pp. 118-123.
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title = "Prognostic value of urine dipstick proteinuria on mortality after acute ischemic stroke",
abstract = "Background and aims Proteinuria is a marker of kidney disease and a strong risk factor for cardiovascular diseases including stroke. This study was aimed at investigating the prognostic value of proteinuria measured by urine dipstick in patients with acute ischemic stroke. Methods This post-hoc analysis of a prospective cohort study included 3404 consecutive patients who had been admitted for acute ischemic stroke between November 2005 and June 2013. Proteinuria was defined as a trace or more of protein on a urine dipstick test routinely performed at admission. Date and cause of death until December 31, 2013 were collected. We investigated the association of proteinuria with all-cause mortality, cardiovascular mortality (defined as ICD-10 codes I00–I99), and non-cardiovascular mortality. Results Proteinuria was present in 12.8{\%} of the 3404 patients. During the mean follow-up period of 3.56 ± 2.22 years, there were 681 cases of all-cause mortality (460 cardiovascular deaths and 221 non-cardiovascular deaths). Multivariate Cox regression analysis showed that the presence of proteinuria was an independent risk factor for all-cause mortality (adjusted hazard ratio [HR] 1.69, 95{\%} confidence interval [CI] 1.40–2.04), cardiovascular mortality (adjusted HR 1.65, 95{\%} CI 1.31–2.08), and non-cardiovascular mortality (adjusted HR 1.59, 95{\%} CI 1.13–2.23). Adding proteinuria to the multivariate Cox models moderately improved the model performance for all-cause mortality (integrated area under curve [95{\%} CI]: from 0.800 [0.784–0.816] to 0.803 [0.788–0.818], p = 0.026). Conclusions Proteinuria, which was detected on a urine dipstick test, was a significant predictor of mortality after acute ischemic stroke.",
author = "Jinkwon Kim and Song, {Tae Jin} and Dongbeom Song and Joonsang Yoo and Baek, {Jang Hyun} and Lee, {Hye Sun} and Nam, {Chung Mo} and Nam, {Hyo Suk} and Kim, {Young Dae} and Jihoe Heo",
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Kim, J, Song, TJ, Song, D, Yoo, J, Baek, JH, Lee, HS, Nam, CM, Nam, HS, Kim, YD & Heo, J 2016, 'Prognostic value of urine dipstick proteinuria on mortality after acute ischemic stroke', Atherosclerosis, vol. 253, pp. 118-123. https://doi.org/10.1016/j.atherosclerosis.2016.08.030

Prognostic value of urine dipstick proteinuria on mortality after acute ischemic stroke. / Kim, Jinkwon; Song, Tae Jin; Song, Dongbeom; Yoo, Joonsang; Baek, Jang Hyun; Lee, Hye Sun; Nam, Chung Mo; Nam, Hyo Suk; Kim, Young Dae; Heo, Jihoe.

In: Atherosclerosis, Vol. 253, 01.10.2016, p. 118-123.

Research output: Contribution to journalArticle

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T1 - Prognostic value of urine dipstick proteinuria on mortality after acute ischemic stroke

AU - Kim, Jinkwon

AU - Song, Tae Jin

AU - Song, Dongbeom

AU - Yoo, Joonsang

AU - Baek, Jang Hyun

AU - Lee, Hye Sun

AU - Nam, Chung Mo

AU - Nam, Hyo Suk

AU - Kim, Young Dae

AU - Heo, Jihoe

PY - 2016/10/1

Y1 - 2016/10/1

N2 - Background and aims Proteinuria is a marker of kidney disease and a strong risk factor for cardiovascular diseases including stroke. This study was aimed at investigating the prognostic value of proteinuria measured by urine dipstick in patients with acute ischemic stroke. Methods This post-hoc analysis of a prospective cohort study included 3404 consecutive patients who had been admitted for acute ischemic stroke between November 2005 and June 2013. Proteinuria was defined as a trace or more of protein on a urine dipstick test routinely performed at admission. Date and cause of death until December 31, 2013 were collected. We investigated the association of proteinuria with all-cause mortality, cardiovascular mortality (defined as ICD-10 codes I00–I99), and non-cardiovascular mortality. Results Proteinuria was present in 12.8% of the 3404 patients. During the mean follow-up period of 3.56 ± 2.22 years, there were 681 cases of all-cause mortality (460 cardiovascular deaths and 221 non-cardiovascular deaths). Multivariate Cox regression analysis showed that the presence of proteinuria was an independent risk factor for all-cause mortality (adjusted hazard ratio [HR] 1.69, 95% confidence interval [CI] 1.40–2.04), cardiovascular mortality (adjusted HR 1.65, 95% CI 1.31–2.08), and non-cardiovascular mortality (adjusted HR 1.59, 95% CI 1.13–2.23). Adding proteinuria to the multivariate Cox models moderately improved the model performance for all-cause mortality (integrated area under curve [95% CI]: from 0.800 [0.784–0.816] to 0.803 [0.788–0.818], p = 0.026). Conclusions Proteinuria, which was detected on a urine dipstick test, was a significant predictor of mortality after acute ischemic stroke.

AB - Background and aims Proteinuria is a marker of kidney disease and a strong risk factor for cardiovascular diseases including stroke. This study was aimed at investigating the prognostic value of proteinuria measured by urine dipstick in patients with acute ischemic stroke. Methods This post-hoc analysis of a prospective cohort study included 3404 consecutive patients who had been admitted for acute ischemic stroke between November 2005 and June 2013. Proteinuria was defined as a trace or more of protein on a urine dipstick test routinely performed at admission. Date and cause of death until December 31, 2013 were collected. We investigated the association of proteinuria with all-cause mortality, cardiovascular mortality (defined as ICD-10 codes I00–I99), and non-cardiovascular mortality. Results Proteinuria was present in 12.8% of the 3404 patients. During the mean follow-up period of 3.56 ± 2.22 years, there were 681 cases of all-cause mortality (460 cardiovascular deaths and 221 non-cardiovascular deaths). Multivariate Cox regression analysis showed that the presence of proteinuria was an independent risk factor for all-cause mortality (adjusted hazard ratio [HR] 1.69, 95% confidence interval [CI] 1.40–2.04), cardiovascular mortality (adjusted HR 1.65, 95% CI 1.31–2.08), and non-cardiovascular mortality (adjusted HR 1.59, 95% CI 1.13–2.23). Adding proteinuria to the multivariate Cox models moderately improved the model performance for all-cause mortality (integrated area under curve [95% CI]: from 0.800 [0.784–0.816] to 0.803 [0.788–0.818], p = 0.026). Conclusions Proteinuria, which was detected on a urine dipstick test, was a significant predictor of mortality after acute ischemic stroke.

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