在TAVR中风后的长期认知结果:TrinetX网络的倾向匹配分析
Olayiwola Bolaji1, Mohammed Nor2, Azka Naeem3
1Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, USA.
International journal of cardiology
|August 21, 2025
概括
通过导管置换大动脉 (TAVR) 后的中风稍微增加了血管痴呆的早期风险. 然而, 控制心血管因素是长期认知健康的关键.
科学领域:
- 心脏病学
- 神经学
- 老年病学
背景情况:
- 脑卒中是透气导管大动脉置换 (TAVR) 的已知并发症.
- 在TAVR中风后对认知功能的长期影响尚未完全了解.
- 这项研究研究了TAVR中风和随后的认知衰退之间的联系.
研究的目的:
- 调查TAVR中风后与血管痴呆症和轻度认知障碍发展之间的关联.
- 在接受TAVR的患者中确定认知衰退的预测因素.
主要方法:
- 利用TriNetX分析网络 (2010-2025) 识别了57,506名65岁以上的TAVR患者.
- 倾向性评分匹配与TAVR后的2662名中风患者和没有中风的2662名患者进行了比较.
- 在手术1,3,5年后评估血管痴呆症和轻度认知障碍.
主要成果:
- 一年后,中风组的血管痴呆率略高 (3. 1% 与 2. 4% 相比),但随着时间的推移,这种差异有所减少.
- 在所有时间点中,轻度认知障碍的发生率在各组之间都是相似的.
- 认知衰退的独立预测因素包括年龄,抗凝剂使用和慢性病.
结论:
- 在TAVR中风后,血管痴呆的风险略微增加.
- 心血管风险因素对TAVR的长期认知结果似乎比中风本身更重要.
- 优化可修改风险因素的管理对于TAVR后的认知保存至关重要.
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