TIA和轻度缺血性中风的潜在原因以及重大血管事件的风险
Philippa C Lavallée1, Hugo Charles1, Gregory W Albers2
1Department of Neurology and Stroke Center, Bichat Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Institut National de la Santé et de la Recherche Médicale (INSERM) Laboratory for Vascular Translational Science (LVTS)-U1148, University Paris-Cité, Paris, France.
JAMA neurology
|October 2, 2023
概括
在经历过渡性缺血性攻击 (TIA) 或轻微缺血性中风的患者中,多种潜在原因的共存是常见的. 这些潜在原因对5年内发生重大血管事件的风险产生重大影响,需要量身定制的预防策略.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 血管医学 血管医学
背景情况:
- 暂时性缺血性发作 (TIA) 和轻微缺血性中风的潜在原因的共存尚未得到充分理解.
- 在这些患者中,主要血管事件的相关5年风险需要进一步调查.
研究的目的:
- 应用ASCOD (动脉样硬化,小血管疾病,心脏病理,其他原因或剖析) 分级系统.
- 评估TIA和轻度缺血性中风的潜在原因的共存.
- 根据这些原因来确定主要血管事件的5年风险.
主要方法:
- 一项国际注册表队列研究 (TIAregistry.org) 招募了4789名TIA或轻度中风患者.
- 患者在21个国家的61个地点接受了1至5年的随访.
- 分析了完成5年随访的3847名患者的数据.
主要成果:
- 在TIA和轻微中风患者中观察到潜在原因 (动脉样硬化,小血管疾病,心脏病理) 的大量共存.
- 患有因果性动脉样硬化症的患者5年内发生重大血管事件的风险增加了4.86倍.
- 患有因果性心脏病理的患者的5年风险增加了4.01倍,而患有因果性缺口性中风的患者的风险增加了2.57倍.
结论:
- 在TIA和轻度缺血性中风患者中潜在原因的共存是显著的.
- 主要血管事件的5年风险因具体的潜在疾病而有很大差异.
- 二次预防策略应该基于病理生理学,而不是采用一种适合所有人的方法.
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