缺血性中风的风险 专利孔卵巢关闭后的缺血性中风
Kasper Bonnesen1, Kasper Korsholm2, Asger Andersen2
1Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Journal of the American College of Cardiology
|October 2, 2024
概括
对于密码性中风,建议通过导管关闭卵孔 (PFO),但中风复发风险仍然高于一般人群. 这项研究显示了关于PFO关闭结果的真实数据,以预防中风.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 公共卫生 公共卫生
背景情况:
- 过导管专利卵孔 (PFO) 关闭是18-60岁患者密码性中风的推治疗方法,PFO相关事件的可能性很高.
- 在控制试验之外的现实世界临床实践中,PFO关闭后中风复发的数据有限.
研究的目的:
- 在常规的临床实践中,调查形孔关闭后中风复发的发生率.
- 将经过PFO关闭的患者的缺血性中风风险与匹配的一般人群队列进行比较.
主要方法:
- 从2008年到2021年,使用丹麦登记册进行了全国性基于人口的队列研究.
- 包括1,162名接受PFO关闭的患者和11,620名来自普通人口的匹配个体.
- 使用权重考克斯回归来估计PFO关闭后4年内缺血性中风的调整危险比率 (HR).
主要成果:
- 在PFO关闭组中,缺血性中风的绝对4年风险为2.5% (95% CI: 1.5%-4.0%),在一般人群中为0.4% (95% CI: 0.3%-0.6%).
- 这代表了PFO关闭患者在4年内缺血性中风风险的绝对增加2.1% (95%CI:0.9%-3.3%).
- 与一般人群相比,PFO关闭患者的缺血性中风调整后危险比为6.3 (95% CI:3.1-12.6).
结论:
- 在日常实践中,在PFO关闭后发生缺血性中风的4年风险与临床试验中的发现相似.
- 尽管有可比的试验数据,但在经过PFO关闭的患者中,缺血性中风的风险仍然明显高于一般人群.
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