腹筋功能障碍和中风和严重出血的风险
John Kundrick1, Karina I Saba1, Aditi Naniwadekar1
1Department of Medicine, Heart and Vascular Institute, University of Pittsburgh Medical Center, PA.
Stroke
|November 11, 2024
概括
左心室扩张功能障碍 (DD) 独立地增加了中风,暂时性缺血性发作 (TIA) 和重大出血事件的风险. 这一发现强调了在患者风险评估和管理策略中考虑DD的重要性.
科学领域:
- 心脏病学 心脏病学
- 血管医学 血管医学
- 临床流行病学临床流行病学
背景情况:
- 左心室扩张功能障碍 (DD) 是已知的心血管不良结果的风险因素,包括心房动.
- DD与发生中风,过渡性缺血性发作 (TIA) 和重大出血事件的风险之间的独立关联尚未确定.
- 这项研究旨在调查DD对中风/TIA和大出血发生率的影响.
研究的目的:
- 确定左心室扩张性功能障碍 (DD) 是否是发生中风/TIA的独立预测因素.
- 评估DD与重大出血事件风险之间的关联.
- 评估DD严重程度对这些不良结果的影响.
主要方法:
- 进行了观察性队列分析,包括至少有一次心脏回声心脏图和至少3个月的随访患者.
- 根据从心声图报告中评估的DD的严重程度,患者被分为四组.
- 排除标准包括先前的中风,TIA或重大出血史. 多变量Cox比例危险模型被用于评估中风/TIA和重大出血的预测因素.
主要成果:
- 研究队列包括96,702名没有DD的患者和18,164名,5,881名和1,340名DD等级I,II和III的患者.
- 在平均3.4年的随访期间,2.4%的患者发生了中风/TIA,4.6%的患者发生了严重出血.
- 在多变量调整后,DD是发生中风/TIA (HR,每级增加1.22;P<0.001) 和大出血 (HR,每级增加1.20;P<0.001) 的显著预测因素.
结论:
- 左心室扩张功能障碍 (DD) 独立地与脑血管事故 (中风/TIA) 和严重出血的风险增加有关.
- DD的严重程度与这些不良事件的风险大小相关.
- 应将DD视为患者风险分层和指导心血管健康管理决策的关键因素.
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