心脏衰竭和中风风险在心房动:从全国性队列研究的时间趋势
Eero Jalli1,2, Ville Langén2,3, Jussi Jaakkola4
1Heart Centre Turku University Hospital and University of Turku Finland.
Journal of the American Heart Association
|July 14, 2025
概括
心力衰竭 (HF) 在心房动 (AF) 患者中显著增加缺血性中风 (IS) 风险. 这种风险已经下降,特别是那些没有先前心肌梗塞 (MI) 的人,但HF仍然是心肌梗塞史患者中风的关键因素.
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:
- 心力衰竭 (HF) 是患有心房动 (AF) 的患者中缺血性中风 (IS) 的已知危险因素.
- 医学进步已经改善了AF和HF的管理,但它们对AF患者中风风险的影响尚不清楚.
- 这项研究调查了AF患者中高频率相关的IS风险的时间趋势.
研究的目的:
- 评估心力衰竭相关的缺血性中风风险在被诊断为心房动的患者中的时间趋势.
- 确定AF和HF管理的变化是否改变了心脏衰竭和心房动患者中风风险之间的关联.
主要方法:
- 全国范围的回顾性队列研究使用芬兰心房抗凝血 (FinACAF) 注册链接.
- 包括芬兰所有在2007年至2018年期间被诊断患有事件AF的患者.
- 在研究期间分析缺血性中风率及其与心力衰竭的关联.
主要成果:
- 总共有229,565名患有发生性AF的患者被确定;17.4%的人在AF诊断时患有HF.
- 在HF和非HF组中,原始IS利率下降. 高频和IS风险之间的关联从30%至50%高 (2007-2010年) 减弱到10%至15%高 (2015-2018年).
- 这种降低主要发生在没有先前心肌梗塞 (MI) 的患者中;在先前心肌梗塞的HF患者中,中风风险保持不变.
结论:
- 与HF相关的中风风险在AF患者中降低了,特别是那些没有心脏病史的人.
- 心力衰竭仍然是AF患者中风的重要风险因素,这些患者有心肌梗塞史.
- 持续监测和量身定制的管理策略对于减轻这一群体中风风险至关重要.
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