心血管疾病的风险与同时发生的隐蔽脑梗塞和未被识别的心肌梗塞的风险
Camiel V J Box1,2, Julie A E van Oortmerssen1, Martijn J Tilly3
1Department of Epidemiology and Biostatistics Erasmus MC Rotterdam The Netherlands.
Journal of the American Heart Association
|October 14, 2025
概括
隐藏性脑梗塞 (CBI) 显著增加了动脉样硬化心血管疾病 (ASCVD) 的风险. 与CBI同时发生的未识别的心肌梗塞 (UMI) 确定了一个需要密集预防治疗的高风险亚组.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 预防医学 预防医学
背景情况:
- 隐藏性脑梗塞 (CBI) 是动脉样硬化心血管疾病 (ASCVD) 的已知危险因素.
- 对CBI患者的最佳管理策略尚不清楚.
- 结合CBI和未被识别的心肌梗塞 (UMI) 的存在可能表明ASCVD特别高风险的亚组.
研究的目的:
- 调查CBI和UMI的同时发生是否能确定ASCVD风险显著更高的患者子组.
- 为患有CBI的个人提供量身定制的预防策略.
主要方法:
- 利用了基于人口的鹿特丹研究 (n=4627,年龄≥45) 的数据.
- 没有先前中风或心肌梗塞的参与者接受了心电图和脑MRI.
- 对心血管风险因素进行调整的考克斯模型被用于评估ASCVD风险,平均随访时间为9.9年.
主要成果:
- 在7.8%的参与者中存在CBI,在2.0%的参与者中存在UMI.
- 患有CBI的人也有更高的可能性也患有UMI (OR,2.3).
- 同时发生的CBI和UMI赋予了最高的ASCVD风险 (HR,5.6),与没有任何条件的个人相比显著增加.
结论:
- CBI与ASCVD风险增加有关.
- 在患有CBI的个体中存在UMI,大大增加了ASCVD风险.
- 这一结合的发现确定了一个关键的子组,需要采取积极的预防干预措施.
更多相关视频
相关概念视频
Ischemic Heart Disease: Overview
2.9K
Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
2.9K
Coronary Artery Disease II: Pathophysiology
367
Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
367
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
354
The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
354
Coronary Artery Disease III: Clinical Manifestations
325
Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
325
Aneurysm II: Clinical Manifestations and Diagnostic Studies
293
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
293
Acute Coronary Syndrome III: Diagnostic Studies
213
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
213


