脑卒中心脏综合征:性是否重要?
Michela Rosso1, Srinath Ramaswamy2, Nino Kvantaliani1
1Department of Neurology University of Pennsylvania Philadelphia PA.
Journal of the American Heart Association
|October 18, 2023
概括
患有急性缺血性中风 (AIS) 的女性患中风后急性心肌损伤的可能性是两倍,这种情况与短期死亡率的增加有关. 需要进一步的研究来了解AIS后心脏事件中的这些性别差异.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 医学中的性别差异.
背景情况:
- 急性缺血性中风 (AIS) 后的心血管并发症是由于并发症或大脑-心轴的干扰引起的.
- 女性更容易受到压力引起的心脏问题,如Takotsubo心肌病变.
- 调查基于性别的差异心脏热素 (cTn) 升高,心脏事件和AIS后的结果至关重要.
研究的目的:
- 为了检查性差异的心脏托罗邦素升高,心脏事件,和急性缺血性中风后的死亡率.
- 为了确定女性是否更容易患上中风后急性心肌损伤.
主要方法:
- 从5个中风中心对AIS患者的回顾性分析.
- 纳入标准:基线cTn升高,测量≥2,排除影响cTn的急性并发病状况.
- 脑卒中后急性心肌损伤的定义:没有急性动脉样硬化冠状动脉疾病或心脏死亡的动态cTn模式.
主要成果:
- 女性 (53%) 年龄较大,心血管风险因素较少,心血管血栓性中风较多,右侧胰岛受影响.
- 女性显示动态cTn模式 (aOR 2.1) 和中风后急性心肌损伤 (aOR 2.1) 的可能性更高.
- 脑卒中后急性心肌损伤与7天死亡率增加相关 (aOR 5.5).
结论:
- 在AIS患者中,基线cTn升高,女性面临中风后急性心肌损伤的风险翻倍.
- 这种女性心肌损伤与显著更高的短期死亡率有关.
- 翻译性研究对于阐明心脏事件和AIS后死亡率的性别差异背后的机制至关重要.
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