心房颤动相关卒中复发的影响因素分析
Analysis of factors influencing recurrence of atrial fibrillation-related stroke
周国庆 1徐裕1
作者信息
- 1. 214400 江阴,江苏省江阴市人民医院
- 折叠
摘要
目的 基于心房颤动相关缺血性卒中后复发率高,本研究旨在探讨心房颤动相关缺血性卒中复发的风险因素.方法 前瞻性收集心房颤动相关缺血性卒中患者,随机分为基于最新指南干预组和一般干预组,观察 1年内卒中复发及竞争事件(非卒中复发引起的死亡)有无差异,利用竞争风险模型探讨影响房颤相关卒中复发的风险因素.结果 基于指南干预组卒中复发率(18.6%)小于一般干预组(32.0%).影响卒中复发风险因素显示:基于指南干预组较一般干预组的风险比HR为 0.5(95%CI:0.3～0.8),女性较男性的 HR为 1.8(95%CI:1.0～3.2),体重指数的HR为 1.5(95%CI:1.3～1.9),既往缺血性卒中史较无卒中史的HR为 2.2(95%CI:1.3～3.8).结论 临床诊疗过程中,制定规律、可操作的基于二级预防指南方案,可有效降低心房颤动相关卒中复发.
Abstract
Objective Based on the high rate of recurrence after AF-related ischemic stroke,this study aimed to investigate the risk factors for recurrence of AF-related ischemic stroke.Methods Patients with AF-related ischemic stroke were prospectively collected and randomly divid-ed into the intervention group based on the latest guidelines and the general intervention group.The differences in stroke recurrence and competing events(deaths not caused by stroke recurrence)within 1 year were observed,and the competing risk model was used to explore the risk factors affect-ing the recurrence of AF-related stroke.Results The rate of stroke recurrence was smaller in the guideline-based intervention group(18.6%)than that in the general intervention group(32.0%).Risk factors affecting stroke recurrence showed an HR of 0.5(95%CI:0.3-0.8)in the guideline-based intervention group versus the general intervention group,an HR of 1.8(95%CI:1.0-3.2)in women versus men,an HR of 1.5(95%CI:1.3-1.9)for body mass index,an HR of 2.2(95%CI:1.3-1.9)for a history of previous ischemic stroke versus no history of stroke(95%CI:1.3-3.2),and an HR of 2.2(95%CI:1.3-3.2)for a history of stroke.95%CI:1.3-3.8).Conclusion The development of a regular,actionable secondary prevention guide-line-based program during clinical practice can be effective in reducing AF-related stroke recurrence.
关键词
缺血性卒中/二级预防/心房颤动/竞争风险模型Key words
Ischemic stroke/Secondary prevention/Atrial fibrillation/Competitive risk model引用本文复制引用
基金项目
江阴市卫生健康委科研项目(2022)(M202207)
出版年
2024
NETL
NSTL
万方数据