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Stroke：心房心脏病与缺血性卒中风险！

2018-03-14 xing.T MedSci原创

心房心脏病缺血性卒中风险
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由此可见，除临床表现的房颤外，心房异常的其他证据与随后的缺血性卒中相关。

新的证据表明房颤发生之前，潜在的心房心脏病可能导致血栓栓塞。近日，卒中领域权威杂志Stroke上发表了一篇研究文章，研究人员评估了各种心房心脏病标志物与缺血性卒中风险之间的关系。

CHS研究（心血管健康研究）前瞻性地招募了≥65岁的社区居住成人。对于这项研究，研究人员排除了基线前诊断为卒中或房颤的参与者。暴露指标包括心房心脏病的几种标志物：心电图V1导联中的基线P波终末电势、超声心动图上的左心房尺寸以及B型利钠肽前体N末端（NT-proBNP），以及房颤事件。研究人员从受试者入选后第一个十年的年度研究访视以及随访期间的住院和门诊医疗保险数据中获取12导联心电图来确定房颤事件。主要结局是发生缺血性卒中。研究人员使用Cox比例风险模型，其中包括所有4种心房心脏病标志物，并且对人口统计特征和已确定的血管风险因素进行了调整。

在3723例无基线卒中和房颤患者中，包含所有房性心脏病标志物的数据，585例受试者（15.7％）在中位数12.9年的随访期间发生了缺血性卒中事件。当所有房性心脏病标志物在Cox模型中合并时，研究人员发现ECG的V1导联中P波终末电势（每1000μV*ms的风险比为1.04; 95％可信区间为1.001-1.08）、NT-proBNP对数转化 （倍增的风险比为1.09; 95％可信区间为1.03-1.16）以及房颤事件（风险比为2.04; 95％可信区间为1.67-2.48）与卒中风险相关，但与左心房尺寸无关（每厘米风险比为0.96; 95％可信区间为0.84-1.10）。

由此可见，除临床表现的房颤外，心房异常的其他证据与随后的缺血性卒中相关。

原始出处：

Hooman Kamel,et al.Atrial Cardiopathy and the Risk of Ischemic Stroke in the CHS (Cardiovascular Health Study).Stroke. 2018. https://doi.org/10.1161/STROKEAHA.117.018870

本文系梅斯医学（MedSci）原创编译整理，转载需授权！


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    2019-02-12 guihongzh

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    2018-03-16 仁心济世

    #卒中风险#

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    2018-03-16 sodoo

    #心房#

    0