在急性冠状动脉综合征后缺血性中风的危险因素
Matilda Hurskainen1, Juho Tynkkynen2,3, Markku Eskola1,4
1Faculty of Medicine and Health Technology Tampere University Tampere Finland.
Journal of the American Heart Association
|July 8, 2023
概括
在急性冠状动脉综合征 (ACS) 之后,中风的发生率更高. 缺血性中风 (IS) 后的关键风险因素包括先前的中风,心房动和心力衰竭,CHA2DS2-VASc得分是强有力的预测因素.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 流行病学 流行病学
背景情况:
- 在急性冠状动脉综合征 (ACS) 之后,中风发生率显著增加.
- 在ACS后了解缺血性中风 (IS) 的风险因素对于患者管理至关重要.
- 之前的中风,心房动和心力衰竭被确定为重要的贡献者.
研究的目的:
- 描述与急性冠状动脉综合征 (ACS) 后发生的缺血性中风 (IS) 相关的危险因素.
- 分析ACS后早期发病 (0-30天) 和晚期发病 (31天至14岁) 的预测因素.
主要方法:
- 对8049名为ACS治疗的患者 (2007-2018) 的回顾性注册表研究.
- 对医院记录和芬兰统计局数据进行深入审查,以确定风险因素.
- 后勤回归和分发危险分析,以评估风险因素与IS发病之间的关联.
主要成果:
- 以前的中风,心房动/动,以及心力衰竭的基利普分类是早期和晚期IS的重大危险因素.
- 左心室喷射率和冠状动脉疾病的严重程度预测了早期的IS;年龄和外周动脉疾病预测了晚期的IS.
- 与较低得分相比,CHA2DS2-VASc得分≥6显著增加了早期发病 (OR 6.63) 和晚期发病IS (SHR 6.03) 的风险.
结论:
- 与高血栓栓塞风险相关的因素是ACS后IS的强有力的预测因素.
- CHA2DS2-VASc评分及其组件有效预测ACS患者的早期和晚期缺血性中风风险.
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