与心房动的基线风险相比,选择性心脏转换会增加缺血性中风的风险多少? 一个全国性的研究研究
Saga Itäinen-Strömberg1, Mika Lehto2,3, Olli Halminen4
1Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, PL 340, 00029 HUS, Meilahden Tornisairaala, Haartmaninkatu 4, Helsinki, Finland.
概括
由于心房动而接受心脏转移的患者在术后的前两周内面临着明显更高的缺血性中风风险. 这种高风险,大约是长期风险的七倍,独立于抗凝治疗.
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:
- 经过心脏转变 (CV) 的心房动 (AF) 患者患有缺血性中风 (IS) 的风险增加.
- 与长期风险相比,这种后CVIS风险的确切程度还不清楚.
- 指南推的抗凝治疗是AF患者的标准.
研究的目的:
- 为了比较直后CV时期的IS率与AF患者的长期风险.
- 要量化超过IS风险在选修CV后的前两周内.
- 评估抗凝血类型和传统风险因素对这种早期后CVIS风险的影响.
主要方法:
- 在芬兰 (2012-2018) 首次接受选择性CV的所有AF患者的全国性基于登记册的研究.
- 随访分为立即 (0-2周) 和随后 (2周至360天) 的CV后期.
- 断点分析和波桑回归用于估计发病率比率和评估相互作用.
主要成果:
- 总共包括9625名AF患者;64.9%使用华法林,35.1%使用非维生素K口服抗凝剂.
- 总体而言,1.0%的患者在CV后一年内经历了IS.
- 在CV后的头2周内,调整后的IS率是后期的7.5倍,独立于抗凝剂或风险因素.
结论:
- 在AF的可选CV之后的前两周,IS的发病率大幅增加.
- 这种早期过度的IS风险大约是随后360天观察到的风险的七倍.
- 在初始的CV后期增加的风险不受使用的抗凝血剂类型或常规中风风险因素的影响.
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