Related Experiment Video
Updated: Nov 7, 2025
A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
Serum Phosphate and 1-Year Outcome in Patients With Acute Ischemic Stroke and Transient Ischemic Attack
Jun-Fang Zhang1,2, Jing Jing2,3,4,5, Xia Meng2,3,4,5
1Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Insights
Serum phosphate levels are linked to outcomes after ischemic stroke. Both low and high phosphate levels may increase risks for stroke recurrence and poor functional outcomes, suggesting a U-shaped association.
Area of Science:
- Neurology
- Cardiology
- Clinical Biochemistry
Background:
- Acute ischemic stroke and transient ischemic attack (TIA) are major causes of long-term disability and mortality.
- Serum phosphate, a crucial electrolyte, plays a role in various physiological processes, but its impact on cerebrovascular events is not fully understood.
Purpose of the Study:
- To investigate the association between serum phosphate levels and 1-year clinical outcomes in patients following acute ischemic stroke or TIA.
- To determine if serum phosphate is an independent predictor of adverse events and functional outcomes.
Main Methods:
- Analysis of 7,353 patients from the China National Stroke Registry III diagnosed with acute ischemic stroke or TIA.
- Patients were stratified into four groups based on serum phosphate quartiles.
- Multivariable regression models (Cox and logistic) were employed to assess the independent association between serum phosphate levels and clinical outcomes, including recurrent stroke, myocardial infarction, other ischemic vascular events, all-cause mortality, and poor functional outcome (modified Rankin Scale score 3–6).
Main Results:
- A U-shaped association was observed between serum phosphate levels and outcomes like recurrent stroke and composite vascular events.
- Compared to the reference group (third phosphate quartile), the lowest quartile (<0.94 mmol/L) showed increased risks for stroke recurrence (aOR 1.31), composite endpoint (aOR 1.26), and poor functional outcome (aOR 1.27).
- The highest phosphate quartile (≥1.2 mmol/L) was independently associated with a significantly higher risk of poor functional outcome (aOR 1.40).
Conclusions:
- Serum phosphate levels may serve as an independent predictor for adverse clinical outcomes after ischemic stroke.
- Both hypophosphatemia and hyperphosphatemia are associated with increased risks of stroke recurrence, composite vascular events, and poor functional outcomes.
- These findings highlight the potential clinical significance of monitoring serum phosphate in stroke patients.
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.
Related Concept Videos
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT