亚临床心房动和栓塞事件之间的时间关系
Michela Brambatti1, Stuart J Connolly1, Michael R Gold1
1From the Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada (M.B., S.J.C., C.A.M., J.N., M.H., W.Q.D., J.S.H.); Clinica di Cardiologia, Università Politecnica delle Marche, Ancona, Italy (M.B., A.C.); Medical University of South Carolina, Charleston (M.R.G.); Cardiology Department, Loreto Mare, Napoli, Italy (C.M.); Queen Mary Hospital, Department of Medicine, University of Hong Kong, Hong Kong, China (C.P.L.); University of Groningen, University Medical Center Groningen, Groningen, Netherlands (I.C.V.G.); J.W. Goethe University, Frankfurt, Germany (S.H.H.); St Jude Medical, Sylmar, CA, and Zaventem, Belgium (M.C.); Clinique du Sud Luxembourg, Arlon, Belgium (G.H.M.); and Evangelical Hospital Bielefeld, Department of Medicine, Division of Cardiology, Bielefeld, Germany (C.W.I.).
通过起器检测到的亚临床心房动 (SCAF) 会增加中风风险. 然而,在ASSERT试验患者中,在中风事件发生前一个月内,SCAF发作很少发生.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 医疗器械 医疗器械
背景情况:
- 心脏起器/除器患者的亚临床心房动 (SCAF) 与较高的中风风险有关.
- 目前尚不清楚SCAF和中风之间的确切时间联系.
- 了解这种关系对于中风预防策略至关重要.
研究的目的:
- 研究亚临床心房动 (SCAF) 与中风或全身栓塞之间的时间关系.
- 为了确定SCAF在植入心脏器件的患者中发生中风事件之前的频率.
主要方法:
- 该ASSERT试验招募了2580名心脏起器/除器和高血压患者 (≥65岁).
- 心脏起器和ICD记录了SCAF发作;电图由专家评判.
- 分析的重点是SCAF的时间>6分钟相对于中风/全身血栓塞.
主要成果:
- 在51起中风/栓塞事件中,26起 (51%) 之前有SCAF.
- 18名患者 (35%) 在中风前检测到SCAF,但在30天内只有4人 (8%).
- 大多数SCAF事件发生在中风前很长时间 (中位数为339天) 或中风后.
结论:
- 虽然SCAF与中风风险增加有关,但在中风前一个月内很少发生.
- 在SCAF检测和中风之间的时间间隔表明其他因素有助于中风的发病.
- 需要进一步的研究来澄清因果途径,并优化SCAF管理以预防中风.
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