揭示心房动和原发性副甲状腺功能障碍症患者中隐藏的中风威胁
Georges Khattar1, Samer Asmar1, Elie Bou Sanayeh1
1Department of Internal Medicine, Staten Island University Hospital/Northwell Health, Staten Island, New York.
The American journal of cardiology
|March 7, 2024
概括
原发性偏甲状腺症 (PHPT) 在心房动 (AF) 患者中显著增加缺血性中风风险. 这一发现独立于CHA2DS2-VASc得分,表明PHPT是评估中风风险的关键因素.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 神经学 神经学
背景情况:
- 目前的指导方针建议在心房动 (AF) 患者中考虑中风风险因素.
- 在AF中发生中风的非传统风险因素,如原发性副甲状腺功能障碍症 (PHPT),尚未得到充分研究.
研究的目的:
- 调查PHPT与AF患者缺血性中风风险之间的关联.
- 确定PHPT是否是AF患者缺血性中风的独立风险因素.
主要方法:
- 使用全国住院患者样本数据库进行回顾性队列研究.
- 倾向性得分匹配用于控制20多个混变量,包括CHA2DS2-VASc得分组件.
- 多变量逻辑回归分析评估了PHPT对缺血性中风风险的独立影响.
主要成果:
- 与没有PHPT的患者相比,患有AF和PHPT的患者的缺血性中风率 (6.0%vs4.4%) 和死亡率 (6.3%vs4.9%) 较高.
- PHPT与缺血性中风风险增加1.4倍和死亡风险增加1.32倍有关,独立于CHA2DS2-VASc得分.
- 亚组分析表明,高CHA2DS2-VASc分数和PHPT的男性的死亡率更高.
结论:
- 初级偏甲状腺症与心房动患者缺血性中风风险增加显著相关.
- 在对AF患者的血栓栓塞瘤风险评估中,应该考虑PHPT,而不仅仅是传统风险评分.
- 潜在的机制包括血管变化,心脏功能障碍和凝血变化.
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