脑卒中风险作为心房持续时间和CHA2DS2-VASc评分的函数
Rachel M Kaplan1, Jodi Koehler2, Paul D Ziegler2
1Division of Cardiology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (R.M.K., R.S.P.).
Circulation
|October 1, 2019
概括
心房的持续时间和CHA2DS2- VASc评分相互作用,预测心脏器件患者的中风风险. 这种相互作用可以帮助指导抗凝治疗决策,以改善患者的治疗结果.
科学领域:
- 心脏病学
- 电生理学
- 医疗信息学
背景情况:
- 前庭 (AF) 持续时间与中风风险有关,但其与心血管植入式电子设备 (CIED) 患者的CHA2DS2- VASc评分的相互作用尚不清楚.
- 了解这种相互作用对于完善中风风险分层和治疗策略至关重要.
研究的目的:
- 研究AF持续时间和CHA2DS2- VASc评分对CIED患者中风和全身血栓塞率的综合影响.
- 确定特定的AF负担和CHA2DS2-VASc得分,表明SSE风险增加.
主要方法:
- 使用了21,768名患有CIED的电子健康记录和Medtronic CareLink数据 (2007年至2017年).
- 在指数日期之前评估的CHA2DS2-VASc得分和分类的AF持续时间 (无,6分钟-23.5小时,>23.5小时).
- 在未服用抗凝血剂的患者中计算年均SSE率.
主要成果:
- 增加AF持续时间和CHA2DS2- VASc得分都与较高的SSE风险相关 (P< 0. 001).
- 对于CHA2DS2- VASc分数0-1,无论AF持续时间如何,SSE的发生率仍然很低.
- 在CHA2DS2- VASc评分≥2和显著的AF负担或CHA2DS2- VASc评分≥5的患者中观察到可操作的中风风险 (> 1%/ 年).
结论:
- 在CIED患者的SSE风险分层中,AF持续时间和CHA2DS2- VASc得分之间存在显著的相互作用.
- 这种综合评估为识别高风险个体提供了更细致的方法.
- 结果可以为个性化抗凝治疗决定提供信息,以减轻中风风险.
更多相关视频
28:13Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
33.9K
08:10Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
2.1K
相关概念视频
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
401
Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
401
01:30Acute Coronary Syndrome I: Introduction
835
Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
835
01:18Dysrhythmias IV: Characteristics of Bradyarrhythmias
501
Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
501
01:23Atherosclerosis IV: Nursing Management
369
Nursing management for a patient with arteriosclerosis involves a comprehensive approach focusing on lifestyle modification, disease monitoring, education, and symptomatic care. Here is an overview of effective nursing strategies:Assessment and Monitoring: Initial and ongoing assessments are crucial. Nurses must document the patient's medical history, including any hypertension, diabetes, hyperlipidemia, and other cardiovascular diseases. Assessments also cover family history and lifestyle...
369
01:17Ischemic Heart Disease: Overview
3.0K
Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
3.0K
01:27Atherosclerosis II: Clinical Manifestations and Diagnostic Tests
475
Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...
475