Tag: pubmed

Health Serv Res. 2026 Jun;61(3):e70141. doi: 10.1111/1475-6773.70141.

ABSTRACT

OBJECTIVE: To estimate the prevalence of Medicaid estate recovery in North Carolina.

STUDY SETTING AND DESIGN: We descriptively analyzed the number of estates, amount recovered, and hardship waiver applications using North Carolina public records data.

DATA SOURCES AND ANALYTIC SAMPLE: The data contained information on the number of estates and amount recovered through Medicaid estate recovery between 2017 and 2021 (n = 2975). Additionally, we analyzed hardship waiver application data for residents who applied and had their application processed between 2018 and 2021 (n = 301).

PRINCIPAL FINDINGS: We found approximately $83 billion was recovered from beneficiaries between 2017 and 2021, or 0.6% of the total cost of North Carolina’s annual Medicaid program and just 0.9% of the fee-for-service annual long-term services and supports Medicaid budget. We found that Black homeowners were more likely to have lower value estates recovered, and overall, more money was recovered from white estates.

CONCLUSION: While states hope Medicaid estate recovery may balance Medicaid spending through increased revenue, our findings demonstrate that these efforts may be insufficient. Policymakers should opt for strategies outside of the Medicaid program that can more precisely target high-net-worth individuals instead of policies like estate recovery that disproportionately impact low-income families.

PMID:42287075 | DOI:10.1111/1475-6773.70141

Beijing Da Xue Xue Bao Yi Xue Ban. 2026 Jun 18;58(3):650-657.

ABSTRACT

OBJECTIVE: To investigate the etiology of chronic sialadenitis, and to analyze their clinical and imaging characteristics.

METHODS: This retrospective analysis reviewed the clinical and imaging data of patients with chronic sialadenitis who underwent sialendoscopy at the Peking University Hospital of Stomatology between January 2021 and August 2023.

INCLUSION CRITERIA: (1) with a history of recurrent swelling of major salivary glands; (2) complete medical records with detailed information about potential causes; (3) sialography images were available; and (4) patients had undergone interventional endoscopy.

EXCLUSION CRITERIA: (1) salivary stones; (2) juvenile recurrent parotitis; (3) IgG4-related sialadenitis; (4) Sjögren syndrome; and (5) neoplastic diseases. Based on the latest research results and clinical data, chronic sialadenitis was classified into radioactive iodine-induced sialadenitis (RAIS), allergy-related sialodochitis (ARS), adult chronic recurrent parotitis (ACRP), sialadenosis with sialodochitis, and idiopathic sialadenitis. Idiopathic sialadenitis was defined as a type of chronic sialadenitis with duct stenosis of unknown etiology (allergic causes, autoimmune disorders, radioactive iodine exposure, history of “parotitis” in childhood, etc.). The proportions of five types of sialadenitis were calculated, and their relationships with age, gender, type of affected glands, number of affected glands, duration of symptoms, and imaging characteristics were statistically analyzed.

RESULTS: A total of 544 consecutive patients diagnosed with chronic sialadenitis were enrolled in this study. They consisted of 192 males and 352 females, and their ages ranged from 14 to 83 years [mean age: (47.44±13.52) years]. Idiopathic sialadenitis accounted for the largest proportion (71.7%, 390 cases), followed by ARS (12.5%, 68 cases), RAIS (6.4%, 35 cases), ACRP (4.8%, 26 cases), and sialadenosis with sialodochitis (4.6%, 25 cases). Among the 2 176 available glands of the 544 patients, 1 120 (51.5%) glands were affected, including 880 (78.6%) parotid glands and 240 (21.4%) submandibular glands. These five types of sialadenitis exhibited significant differences in gender, age, type and number of affected glands, and duration of symptoms (P < 0.05). Among them, RAIS patients showed the lowest male to female ratio (male ∶ female=1 ∶ 4.83), ARCP patients were the youngest [(32.50±8.60) years], and RAIS and ARS patients had relatively higher number of affected glands. Sialography showed ductal atresia in 23.2% of affected glands with ARIS, “snowflake” pattern in 46.5% of affected glands with ARS, “punctate and globular” ectasia of terminal ducts in 80.4% of affected glands with ARCP, and clustered branch ducts in 71.4% of affected glands with sialadenosis with sialodochitis. Moreover, stenosis and/or dilatation of the main and branch ducts represented the most typical sialography appearance of idiopathic sialadenitis.

CONCLUSION: Idiopathic sialadenitis, RAIS, ARS, ACRP, and sialadenosis with sialodochitis are the five common types of chronic sialadenitis. Among these, idiopathic sialadenitis is the most common type of chronic sialadenitis. Clarification of the etiology, clinical manifestations and imaging characteristics of chronic sialadenitis is important for clinicians to develop personalized treatment plans and improve treatment outcomes.

PMID:42287062

Beijing Da Xue Xue Bao Yi Xue Ban. 2026 Jun 18;58(3):641-649.

ABSTRACT

OBJECTIVE: To explore the promotion of dynamic distraction on osteogenic differentiation of human bone marrow mesenchymal stem cells (hBMMSCs) in three-dimensional culture.

METHODS: Dynamic stretching in a three-dimensional culture for hBMMSCs was achieved with proportions set at 5%, 10%, and 20%, a frequency of 0.5 Hz, and a dynamic stretching duration of 2 hours per day. Static culture was used as the control group. Deformation of hBMMSCs induced by dynamic stretching was observed through cytoplasmic fluorescence staining. After 7 days of dynamic stretching culture, the impact of dynamic stretching on the viability of hBMMSCs was observed through cell live/dead staining. The effect of dynamic stretching on the osteogenic differentiation of hBMMSCs was observed through alkaline phosphatase (ALP) staining and the expression of osteogenic related genes and proteins after 7 days of dynamic stretching culture.

RESULTS: Dynamic stretching in a three-dimensional culture for hBMMSCs was successfully constructed, which could achieve different durations, frequencies, and ratios of dynamic stretching. Dynamic stretching led to deformation of hBMMSCs, and the greater the stretching ratio, the more pronounced the cell deformation, transitioning from a circular to a flat oval shape. After 7 days of dynamic stretching culture, hBMMSCs in the static control group and dynamic stretching groups were mostly green stained live cells, with only a few red stained dead cells. The difference in the proportion of live cells between the groups was not statistically significant (P>0.05). The ALP staining in the dynamic stretching group was deeper than that in the static control group, and the number of ALP staining positive cells observed under the microscope was higher. The expression of osteogenic related genes and proteins increased after 7 days of dynamic stretching culture, and the difference was statistically significant (P < 0.05). Among them, the dynamic stretching group with 10% had the deepest ALP staining, the highest number of positive cells, and the most significant increase in the expression of osteogenic related genes and proteins compared with the static control group.

CONCLUSION: Dynamic stretching caused deformation of hBMMSCs without a significant impact on cell viability, and it could effectively promote the osteogenic differentiation of hBMMSCs.

PMID:42287061

Beijing Da Xue Xue Bao Yi Xue Ban. 2026 Jun 18;58(3):631-640.

ABSTRACT

OBJECTIVE: Next-generation sequencing (NGS) technology was used to analyze the gene mutation profile of lymph node metastases in renal cell carcinoma, and the molecular characteristics associated with poor prognosis were found, providing new ideas for mechanism research and treatment.

METHODS: Retrospective clinical data collection was conducted on 31 patients with lymphoid metastatic renal cell carcinoma and 21 patients with non-metastatic renal cell carcinoma. A total of 81 formalin-fixed paraffin-embedded tissue samples were retrieved from the Department of Pathology, including primary tumor, lymph node metastasis, and distant metastasis samples. The gene mutation profiles of the patients were examined using next-generation sequencing technology. The patients were followed up to analyze the correlation between lymph node metastasis and patient prognosis.

RESULTS: The lymph node metastasis group showed differences in tumor size (P=0.006), World Health Organization (WHO)/International Society of Urological Pathology (ISUP) grade (P=0.002), T stage (P=0.003) and tumor thrombus (P=0.025) compared with non-metastatic renal cell carcinoma. The most commonly mutated genes in our cohort were the tumor suppressor genes VHL (38%), PBRM1 (22%), and SETD2 (20%). More-over, copy number variations were associated with tumor metastasis, and some mutation features were highly similar to known mutation patterns. There was a difference in mutation frequency between the patients in the metastasis group and samples in the non-metastasis group. The mutation frequency of most genes in the metastasis group was higher, however, Reactome pathway enrichment analysis did not show statistically significant differences in the shared enriched pathways between the two groups. There was a strong degree of concordance between the tumor’ s primary and metastatic foci in the same patient, and genomic indicators [such as purity, ploidy, weighted-genomic integrity index (WGII), and intra-tumor heterogeneity (ITH)] as well as clonal and subclonal composition analysis further supported this consistency. The overall survival (OS) was higher in the patients without metastases (P=0.041), and specific gene mutations (such as IGF2R, JUN, EPHA5, and FH) were associated with poorer prognosis. To facilitate distant metastasis, lymph nodes might function as a “metastatic pool”.

CONCLUSION: The multigene NGS evaluates multiple relevant markers simultaneously, revealing several genetic alterations in the patients with lymphatic metastatic renal cell carcinorma. NGS-based molecular analysis can assist clinicians in assessing a patient’ s prognosis and identifying novel, potentially therapeutic mechanisms.

PMID:42287060

Beijing Da Xue Xue Bao Yi Xue Ban. 2026 Jun 18;58(3):624-630.

ABSTRACT

OBJECTIVE: To delineate differences in lymphocyte subset expression between patients with infectious pneumonia and immune-related interstitial lung disease (IRILD), to assess the immune status across distinct pneumonia types, and to provide novel laboratory markers through immunological profiling to effectively differentiate pneumonias.

METHODS: A total of 78 patients sequentially enrolled from Peking University People’ s Hospital between January 2023 and March 2024 were stratified into three groups: 27 with infectious pneumonia, 27 with isolated immune-related interstitial lung disease (IRILD), and 24 with IRILD complicated by infection. Fifty age-matched healthy individuals undergoing routine physical examinations during the same period served as controls. Peripheral lymphocyte subsets were quantified in all subjects by multiparametric flow cytometry.

RESULTS: There was no statistically significant difference in age between the pneumonia patients and the healthy control group in this study (P>0.05). Analysis of laboratory parameters revealed that compared with the IRILD group, the infectious pneumonia group demonstrated significantly elevated levels of neutrophils, C-reactive protein, procalcitonin (PCT), erythrocyte sedimentation rate (ESR), D-dimer, and fibrinogen (P < 0.05), while the IRILD with superimposed infection group exhibited significantly increased levels of PCT, ESR, and immunoglobulin G (P < 0.05). At the lymphocyte subset level, compared with the control group, the infectious pneumonia group exhibited significantly decreased counts of T cells, B cells, natural killer (NK) cells, CD4⁺T cells, and the CD4⁺/CD8⁺ ratio (P < 0.05). Similarly, compared with the control group, the IRILD group showed significantly reduced counts of T cells, B cells, CD4⁺T cells, and the CD4⁺/CD8⁺ ratio (P < 0.05). Furthermore, compared with the control group, the IRILD-with-infection group demonstrated significantly lower counts of T cells, B cells, NK cells, CD4⁺T cells, and CD8⁺T cells (P < 0.05). Compared with the IRILD group, the infectious pneumonia group had a significantly lower NK cell count (P < 0.05). Additionally, compared with the IRILD group, the IRILD-with-infection group displayed significantly reduced counts of NK cells and CD8⁺T cells (P < 0.05).

CONCLUSION: The study revealed significant variations in lymphocyte subset profiles among the distinct pneumonia groups, providing novel insights with potential diagnostic value for differentiating between pneumonia types.

PMID:42287059

Beijing Da Xue Xue Bao Yi Xue Ban. 2026 Jun 18;58(3):616-623.

ABSTRACT

OBJECTIVE: To investigate the effect of long non-coding RNA (LncRNA) differentiation antagonizing non-protein coding RNA (DANCR) on the immune microenvironment of glioma cells by regulating the miR-656/bone morphogenetic protein receptor type 1A (BMPR1A) axis.

METHODS: The expression levels of DANCR, miR-656 and BMPR1A in glioma cells were detected by quantitative real-time polymerase chain reaction (qRT-PCR). The U87 cells were transfected or co-transfected to form the following groups: sh-DANCR (transfected with sh-DANCR), overexpression (pcDNA 3.1) DANCR (transfected with pcDNA 3.1 DANCR), NC sh (transfected with negative control sh), pcDNA 3.1 (transfected with pcDNA 3.1 vector), sh-DANCR + miR-656 inhibitor (co-transfected with sh-DANCR and miR-656 inhibitor), sh-DANCR + NC inhibitor (co-transfected with sh-DANCR and NC inhibitor), sh-DANCR + pcDNA 3.1 BMPR1A (co-transfected with sh-DANCR and pcDNA 3.1 BMPR1A), and sh-DANCR + pcDNA 3.1 (co-transfected with sh-DANCR and pcDNA 3.1 BMPR1A). The untreated U87 cells were used as the blank group. The proliferation of U87 cells was detected by CCK-8; invasion and migration were detected by Transwell assay; apoptosis was detected by flow cytometry; the expression of DANCR, miR-656, and BMPR1A mRNA in cells was detected by qRT-PCR; the targeting relationship between DANCR and miR-656 was verified by dual-luciferase; and BMPR1A and immune escape factors [programmed death receptor 1 (PD-1) and programmed death-ligand 1 (PD-L1)] were detected by Western blot.

RESULTS: The mRNA expressions of DANCR and BMPR1A in U87, A172, LN229 and U251 cells were significantly increased, while the expression of miR-656 was significantly decreased compared with those in NHA cells (P < 0.05). Compared with the blank group and sh-DANCR group, the proliferation rate, invasion, migration number, DANCR, BMPR1A mRNA, BMPR1A, PD-1, PD-L1 expression of U87 cells in the sh-DANCR group were obviously reduced, while the apoptosis rate and miR-656 expression were obviously increased (P < 0.05). Compared with the pcDNA 3.1 group, the proliferation rate, invasion, migration number, DANCR, BMPR1A mRNA, BMPR1A, PD-1, and PD-L1 expression of U87 cells in the pcDNA 3.1 DANCR group were obviously increased, while the apoptosis rate and miR-656 expression were obviously reduced (P < 0.05). Compared with the sh-DANCR +NC inhibitor group, the proliferation rate, invasion, migration number, BMPR1A mRNA, BMPR1A, PD-1, and PD-L1 expression of U87 cells in the sh-DANCR+miR-656 inhibitor group were obviously increased, and the apoptosis rate and miR-656 expression were obviously reduced (P < 0.05), while the expression of DANCR was not obvious (P>0.05). Compared with the sh-DANCR+pcDNA 3.1 group, the proliferation rate, invasion, migration number, BMPR1A mRNA, BMPR1A, PD-1, and PD-L1 expression of U87 cells in the sh-DANCR+pcDNA 3.1 BMPR1A group obviously increased, and the apoptosis rate obviously decreased (P < 0.05), while here was no statistically obvious difference in miR-656 expression and DANCR expression (P>0.05). DANCR and miR-656 had a targeted negative regulatory relationship.

CONCLUSION: LncRNA DANCR improves the immune microenvironment of glioma cells and inhibits the malignant behavior development of cancer cells by regulating the miR-656/BMPR1A axis.

PMID:42287058

Beijing Da Xue Xue Bao Yi Xue Ban. 2026 Jun 18;58(3):584-591.

ABSTRACT

OBJECTIVE: To examine the impact of effective health information acquisition on hemophilia-related health literacy among adult caregivers of children and adolescents with hemophilia in China, and to provide evidence-based recommendations for improving adult caregivers’ hemophilia-related health literacy.

METHODS: Data were derived from the 2024 nationwide multicenter cross-sectional survey, “Health Literacy Survey of Hemophilia Patients in China”. A total of 856 adult caregivers of children and adolescents with hemophilia were recruited through convenience sampling. To explore the differences in hemophilia-related health literacy and effective health information acquisition levels among caregivers across different demographic characteristics, univariate ANOVA and independent-samples t test were adopted for statistical analysis. The bootstrap method was employed to test the mediating role of effective health information acquisition in the relationship between hemophilia-related health literacy and its influencing factors.

RESULTS: The overall level of hemophilia-related health literacy among caregivers of minor patients with hemophilia was relatively low, with an average score of 11.87±2.92. Only 20.68% of the caregivers for underage patients with hemophilia had acquired hemophilia-related health literacy. Univariate ANOVA analysis indicated that marital status, educational attainment, annual household income, registered residence location, and employment status significantly influenced adult caregivers ‘ hemophilia-related health literacy (P < 0.05). The utilization rate of various health information channels by caregivers of underage hemophilia patients exceeded 70%. Over 95% of the caregivers reported obtaining hemophilia-related health information from medical staff and hemophilia patient organizations. While, the caregivers demonstrated relatively low overall effective health information acquisition (34.43±16.50). The level of effective health information acquisition was related to educational attainment, place of household registration and employment status. Caregivers with higher educational attainment, urban household registration and full-time employment had a higher level of effective health information acquisition, and the differences were statistically significant (P < 0.05). The mediation analysis showed that the level of effective health information acquisition was positively correlated with hemophilia health literacy (P < 0.01), and effective health information acquisition played a partial mediating role between “education attainment” and “hemophilia health literacy”, “employment status” and “hemophilia health literacy”, and “place of household registration” and “hemophilia health literacy” (P < 0.05). Higher educational attainment and favorable employment status not only directly improved health literacy, but also indirectly enhanced it by promoting effective information acquisition. Compared with urban household registration, rural household registration had a negative impact on health literacy in patients with hemophilia. Meanwhile, effective information acquisition also exerted a partial mediating effect between registered residence location and health literacy.

CONCLUSION: The hemophilia-related health literacy among caregivers of underage hemophilia patients is relatively low. Enhancing adult caregivers’ effective health information acquisition of health information will improve their hemophilia-related health literacy. Tailored strategies to optimize effective health information acquisition for adult caregivers with varying sociodemographic characteristics could indirectly contribute to improved health literacy outcomes.

PMID:42287054

Beijing Da Xue Xue Bao Yi Xue Ban. 2026 Jun 18;58(3):575-583.

ABSTRACT

OBJECTIVE: Based on protection motivation theory (PMT), this study aimed to examine the current status of e-cigarette cessation intention and cessation behavior, as well as their associated factors, among adult e-cigarette users in China.

METHODS: This was a cross-sectional study. The data were derived from a nationwide “E-cigarette Use Survey” conducted in 2023, covering 31 provinces (municipality, autonomous region) in China. A total of 550 current e-cigarette users aged 18-44 years were selected as the study population. After adjusting for sociodemographic variables, multiple linear regression models were used to identify factors associated with e-cigarette cessation intention, while binary Logistic regression models were applied to examine factors associated with e-cigarette cessation behavior. In addition, subgroup analyses were conducted according to smoking status to explore potential differences among exclusive e-cigarette users and dual users of e-cigarettes and combustible cigarettes.

RESULTS: The mean score of e-cigarette cessation intention was 3.52±0.96, and 31.64% of participants reported having attempted to quit e-cigarettes. After adjustment for covariates, cessation intention was associated with both the threat appraisal and coping appraisal pathways within the PMT framework. Specifically, in the threat appraisal pathway, severity (β=0.14) and vulnerability (β=0.12) were positively associated with cessation intention, whereas perceived extrinsic rewards (β=-0.12) were negatively associated. In the coping appraisal pathway, both response efficacy (β=0.26) and self-efficacy (β=0.28) were positively associated with cessation intention. Regarding cessation behavior, only severity (OR=1.58) in the threat appraisal pathway was positively associated, and cessation intention was also positively associated with cessation behavior. Subgroup analyses further showed that, regardless of smoking status, cessation intention was positively associated with both the threat appraisal pathway (β=0.20, β=0.31) and the coping appraisal pathway (β=0.23, β=0.21).

CONCLUSION: PMT provides a valuable theoretical framework for understanding e-cigarette cessation among adults. Factors related to the threat appraisal pathway are associated not only with cessation intention but also with actual cessation behavior. More-over, the associations of PMT-related factors vary across different smoking status subgroups. These findings suggest that future e-cigarette control policies and interventions could focus on enhancing risk perception and cognitive awareness, and develop more targeted cessation strategies for specific subgroups.

PMID:42287053

Beijing Da Xue Xue Bao Yi Xue Ban. 2026 Jun 18;58(3):551-559.

ABSTRACT

OBJECTIVE: To identify real-world physical activity patterns in older adults using objective measurements from wearable devices, and to analyze the associations between these patterns and gut microbiota composition.

METHODS: Based on data collected from a real-world health management project, a total of 743 participants from Eastern, Central, and Northern China were enrolled between January 2018 and June 2025. A 180-day objective physical activity dataset prior to fecal sampling was collected via smart wearable devices to extract features including mean daily steps, coefficient of variation of steps, and the proportion of active days. Fecal samples underwent 16S ribosomal RNA (rRNA) gene (V3-V4 region) amplicon sequencing to obtain genus-level relative abundance matrices. Covariates, including demographics, lifestyle, and chronic disease history, were collected via questionnaires and physical examinations. The discriminative dimensionality reduction via learning a tree (DDRTree) algorithm combined with K-means clustering was applied to identify physical activity phenotypes. Alpha diversity was evaluated using the Shannon index (Kruskal-Wallis test), and beta diversity was assessed using covariate-adjusted permutational multivariate analysis of variance (PERMANOVA) based on Bray-Curtis distance. Multivariable linear regression with false discovery rate (FDR) correction was used to screen differential taxa. A microbial risk score (MRS) was constructed based on taxa with a raw P < 0.05, defined as the difference between the standardized abundance of beneficial and harmful taxa. Co-occurrence networks were constructed to evaluate micro-ecological topological structures.

RESULTS: The cohort comprised 381 (51.3%) individuals aged 60-74 years and 362 (48. 7%) aged ≥75 years. Compared with the 60-74 group, the ≥75 group had higher prevalences of hypertension (45.9% vs. 36.7%, P=0.045) and heart disease (34.0% vs. 25.2%, P=0.032), higher systolic blood pressure (median 130 mmHg vs. 120 mmHg, P < 0.001), and fewer mean daily steps (median 6 200 steps vs. 7 000 steps, P < 0.001). Clustering identified three activity patterns: active group (n=143, 19.2%; high steps, low variation, high adherence), moderate group (n=429, 57.7%), and irregular group (n=171, 23.0%; low steps, high variation, low adherence). The active group exhibited the lowest prevalences of hypertension (35.0%) and heart disease (21.7%), and the lowest systolic blood pressure (mean 124.4 mmHg), whereas the irregular group showed the highest values (51.5%, 40.4%, and 127.6 mmHg, respectively). Alpha diversity showed no significant differences among the groups. After adjusting for covariates, physical activity patterns showed no statistically significant effect on beta diversity (R²=0.003 7, P=0.115). Compared with the irregular group, two genera in the active group showed significant differences (P < 0.05). Specifically, the relative abundance of Roseburia in the active group was significantly lower than that in the irregular group (P < 0.05), and the relative abundance of Butyricimonas was also significantly lower than that in the moderate group (P < 0.01). However, these differences did not remain statistically significant after FDR correction. The MRS exhibited a significant gradient distribution across the groups, with the active group scoring the highest (P < 0.001). Co-occurrence network analysis revealed that the active group had the highest network density and proportion of positive correlations (84.5%), whereas the irregular group had the lowest (60.3%).

CONCLUSION: Physical activity patterns identified from wearable device data are associated with gut microbiota composition and ecological network characteristics in older adults. Active and regular physical activity patterns indicate a higher MRS and more stable microbial co-occurrence networks, suggesting potential associations between activity regularity and gut microbial ecology, though causal inference requires longitudinal confirmation.

PMID:42287050

Beijing Da Xue Xue Bao Yi Xue Ban. 2026 Jun 18;58(3):536-542.

ABSTRACT

OBJECTIVE: To systematically evaluate the association between anticoagulant therapy and long-term outcomes (all-cause mortality, stroke recurrence, and hemorrhage events) in elderly patients with cardiogenic stroke, thereby providing evidence for clinical decision-making.

METHODS: A retrospective cohort study design was adopted. A total of 567 elderly patients with cardiogenic stroke from Liang-xiang Hospital in Fangshan District, Beijing, were followed up for 4 years. The primary outcomes included all-cause mortality, stroke recurrence, and hemorrhage events (including intracranial hemorrhage, gastrointestinal bleeding, urinary system bleeding, gingival bleeding, and skin and mucosal hemorrhage). Multivariable Logistic regression was used to analyze the association between anticoagulant therapy and each outcome. All statistical analyses were performed using R software (version 4.2.2).

RESULTS: A total of 567 elderly patients were included in this study, with a mean age of (73.92±9.70) years and 49.74% being male. Among them, 142 patients (25.04%) received anticoagulant therapy. During the follow-up period, 266 deaths occurred (crude mortality rate: 46.91%), 107 patients had stroke recurrence (cumulative recurrence incidence: 18.87%), and 28 patients experienced bleeding events (cumulative hemorrhage incidence: 4.94%). Multivariable Logistic regression showed that elderly patients with cardiogenic stroke who received anticoagulant therapy had a significantly lower risk of death (OR=0.22, 95%CI: 0.12, 0.41, P < 0.001). No significant association was found between anticoagulant therapy and the risk of stroke recurrence or hemorrhage (P>0.05).

CONCLUSION: Anticoagulant therapy is beneficial in reducing the risk of all-cause mortality in elderly patients with cardiogenic stroke, and no evidence was found that anticoagulant therapy increases the risk of stroke recurrence or hemorrhage. The study supports considering anticoagulant therapy to improve long-term survival in elderly patients with cardiogenic stroke, and larger prospective studies are still needed to further validate the findings.

PMID:42287048