"ABC-中风风险评分和心房的查对中风预防的影响:随机LOOP研究的结果
Lucas Yixi Xing1,2, Søren Zöga Diederichsen1,3, Søren Højberg3
1Department of Cardiology Copenhagen University Hospital-Rigshospitalet Copenhagen Denmark.
Journal of the American Heart Association
|February 14, 2024
概括
该ABC-中风得分识别了在没有心房动 (AF) 的老年人中较高的中风风险. 然而,它可能无法有效指导AF查或预防性治疗决策.
科学领域:
- 心脏病学 心脏病学
- 预防医学 预防医学
- 临床风险分层的临床风险分层
背景情况:
- 该ABC-中风评分是预测中风或全身血栓塞 (SE) 在心房动 (AF) 患者的验证工具.
- 它在AF-naïve个体和指导AF查中的实用性尚未完全阐明.
研究的目的:
- 为了评估ABC-中风得分在预测AF-naïve个体中风的有效性.
- 评估其在风险分层中的有用性,以便在这个人群中进行AF查.
主要方法:
- 对LOOP研究 (NCT02036450) 的二次分析,该研究随机选择了6004名AF-naïve个体 (70-90岁) 与中风风险因素.
- 参与者被分配到用植入式循环记录器或常规护理进行持续的心电图监测.
- 基线ABC中风得分被用于将参与者分为风险组 (≤1%/年与>1%/年).
主要成果:
- 较高的ABC-中风得分 (>1%年风险) 与中风/SE,中风/SE/心血管死亡和全因死亡的风险增加有关.
- 在任何ABC中风风险层中,在植入式循环记录仪查与常规护理相比,没有观察到这些结果的显著减少.
- 在查策略和ABC中风风险评分之间没有发现显著的相互作用.
结论:
- 在老年人中,AF-naïve个体具有中风风险因素,ABC-中风得分可以识别那些中风风险较高的人.
- 评分能够精确确定哪些个人最能从AF查和随后的预防性治疗中获益是有限的.
- 这些发现产生了假设,并表明需要进一步研究.
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