机构：[1]National Clinical Research Center for Kidney Disease, the State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China[2]Institute of Biomedicine, Anhui Medical University, Hefei, China[3]Shenzhen Evergreen Medical Institute, Shenzhen, China[4]Department of Neurology, Guangdong Hospital of Traditional Chinese Medicine, Guangzhou, China广东省中医院[5]Department of Cardiology,Peking University First Hospital, Beijing, China[6]Department of Pharmacy,Peking University First Hospital, Beijing, China.
Background Data on the association between serum bilirubin and the risk of stroke are limited and inconclusive. We aimed to evaluate the association between serum bilirubin and the risk of first stroke and to examine any possible effect modifiers in hypertensive patients. Methods and Results Our study was a post hoc analysis of the CSPPT (China Stroke Primary Prevention Trial). A total of 19 906 hypertensive patients were included in the final analysis. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% CIs for the risk of first stroke associated with serum bilirubin levels. The median follow-up period was 4.5 years. When serum total bilirubin was assessed as tertiles, the adjusted HR of first ischemic stroke for participants in tertile 3 (12.9-34.1 μmol/L) was 0.75 (95% CI, 0.59-0.96), compared with participants in tertile 1 (<9.3 μmol/L). When direct bilirubin was assessed as tertiles, a significantly lower risk of first ischemic stroke was also found in participants in tertile 3 (2.5-24.8 μmol/L) (adjusted HR, 0.77; 95% CI, 0.60-0.98), compared with those in tertile 1 (<1.6 μmol/L). However, there was no significant association between serum total bilirubin (tertile 3 versus 1: adjusted HR, 1.45; 95% CI, 0.89-2.35) or direct bilirubin (tertile 3 versus 1: adjusted HR, 1.27; 95% CI, 0.76-2.11) and first hemorrhagic stroke. Conclusions In this sample of Chinese hypertensive patients, there was a significant inverse association between serum total bilirubin or direct bilirubin and the risk of first ischemic stroke.
基金：
the National Key
Research and Development Program (2016YFE0205400, 2018ZX09739010,
and 2018ZX09301034003); the National Natural Science Foundation of
China (81730019 and 81973133); the Science and Technology Planning
Project of Guangzhou, China (201707020010); the Science, Technology
and Innovation Committee of Shenzhen (JSGG20170412155639040 and
GJHS20170314114526143); and the Economic, Trade and Information
Commission of Shenzhen Municipality (20170505161556110 and
20170505160926390).
第一作者机构：[1]National Clinical Research Center for Kidney Disease, the State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China
共同第一作者：
通讯作者：
通讯机构：[1]National Clinical Research Center for Kidney Disease, the State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China[*1]National Clinical Research Center for Kidney Disease, the State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China
推荐引用方式(GB/T 7714)：
Jiancheng Wang,Xianglin Zhang,Zhuxian Zhang,et al.Baseline Serum Bilirubin and Risk of First Stroke in Hypertensive Patients[J].JOURNAL OF THE AMERICAN HEART ASSOCIATION.2020,9(12):doi:10.1161/JAHA.119.015799.
APA：
Jiancheng Wang,Xianglin Zhang,Zhuxian Zhang,Yuanyuan Zhang,Jingping Zhang...&Xianhui Qin.(2020).Baseline Serum Bilirubin and Risk of First Stroke in Hypertensive Patients.JOURNAL OF THE AMERICAN HEART ASSOCIATION,9,(12)
MLA：
Jiancheng Wang,et al."Baseline Serum Bilirubin and Risk of First Stroke in Hypertensive Patients".JOURNAL OF THE AMERICAN HEART ASSOCIATION 9..12(2020)
医学