缺血性中风患者无症状冠状动脉疾病的患病率:PRECORIS研究
David Calvet1, Emmanuel Touzé, Olivier Varenne
1Department of Neurology, Centre HospitalierSainte-Anne, Paris Descartes University, Centre de Psychiatrie et Neurosciences INSERM UMR 894, Paris, France.
Circulation
|March 31, 2010
概括
大约五分之一的经历过缺血性中风或过渡性缺血性攻击的患者有显著的无症状冠状动脉疾病 (CAD). 这种患病率与血管风险因素和动脉狭窄有关,强调需要进行全面的心血管评估.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 血管医学 血管医学
背景情况:
- 冠状动脉疾病 (CAD) 是缺血性中风患者死亡和残疾的主要原因.
- 在中风患者中无症状CAD的患病率尚未确立,但它可能会影响预防策略.
- 识别无症状CAD对于有效管理中风患者至关重要.
研究的目的:
- 在患有缺血性中风或短暂缺血性发作 (TIA) 的患者中确定显著无症状冠状动脉疾病 (CAD) 的患病率.
- 调查无症状CAD与传统血管风险因素之间的关联.
- 探索无症状CAD和宫脑动脉样硬化之间的关系.
主要方法:
- 一项涉及300名年龄在45-75岁的非致残,非心血管栓塞性缺血性中风或TIA患者的研究,没有先前的CAD病史.
- 利用64段计算机断层扫描冠状动脉扫描来评估CAD的严重程度 (>或=50%的狭窄).
- 进行了详细的宫大脑动脉检查,并评估了血管风险因素,包括弗雷明汉风险评分.
主要成果:
- 在被研究的患者中,显著无症状CAD (>或=50%狭窄) 的患病率为18%.
- 无症状的CAD独立地与较高的血管风险得分,过度饮酒和关节指数<0.9.9相关.
- 在无症状的CAD和显著的宫大脑动脉狭窄的存在之间发现了强烈的相关性.
结论:
- 近五分之一的缺血性中风或TIA患者表现出显著的无症状冠状动脉疾病.
- 脑关动脉狭窄是无症状CAD的重要预测因素,与传统的血管风险因素一起.
- 这些发现强调了评估中风患者冠状动脉样硬化的重要性,即使没有心脏症状.
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