Circulation:心房颤动持续时间和CHA2DS2-VASc评分影响卒中发病

2019-10-15 国际循环编辑部 国际循环

对心血管植入式电子设备(CIED)患者的研究表明,心房颤动(AF)持续时间与卒中风险存在相关性,尽管与CHA2DS2-VASc评分的相互作用定义不明确。Rachel M.Kaplan等开展的一项研究目的是评估CHA2DS2-VASc评分和AF持续时间对CIED患者卒中和全身性栓塞(SSE)发生率的影响。 研究者将来自Optum©电子健康记录(EHR)去识别化数据库(2007~2017)的

对心血管植入式电子设备(CIED)患者的研究表明,心房颤动(AF)持续时间与卒中风险存在相关性,尽管与CHA2DS2-VASc评分的相互作用定义不明确。Rachel M.Kaplan等开展的一项研究目的是评估CHA2DS2-VASc评分和AF持续时间对CIED患者卒中和全身性栓塞(SSE)发生率的影响。
 
研究者将来自Optum©电子健康记录(EHR)去识别化数据库(2007~2017)的数据连接到能连续进行AF监测的CIED的Medtronic CareLinkTM数据库。索引日期指定为设备植入后6个月或EHR后1年的可用数据。在索引日期之前通过EHR数据评估CHA2DS2-VASc得分。在索引日期之前的6个月中评估最大每日AF负荷(无AF,6 min~23.5 h以及> 23.5 h)。计算索引日期后SSE率。
 
结果显示,在21 768例非抗凝CIED患者(68.6±12.7岁,男性63%)中,AF持续时间延长(P<0.001)和CHA2DS2-VASc评分增加(P<0.001)均与SSE年风险显著相关。CHA2DS2-VASc为0~1患者的SSE率低,无论使用设备检测到的AF持续时间如何。但CHA2DS2-VASc为2 AF>23.5 h的患者,CHA2DS2-VASc为3~4 AF>6 min的患者和CHA2DS2-VASc≥5即使无AF的患者卒中风险超过定义为>1%/年的可行阈值。
 
AF持续时间与CHA2DS2-VASc评分存在相互作用,这可进一步将AF患者的SSE进行风险分层,并有助于指导抗凝治疗。
 
参考文献

Rachel M. Kaplan, Jodi Koehler, Paul D. Ziegler, et al. Stroke Risk as a Function of Atrial Fibrillation Duration and CHA2DS2-VASc Score. Circulation. Sep 2019.

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    2019-12-02 quxin068
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    2019-12-08 huperzia
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    2019-10-17 zhwj
  5. [GetPortalCommentsPageByObjectIdResponse(id=1938999, encodeId=6bf0193899939, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Mon Dec 02 16:16:00 CST 2019, time=2019-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2021200, encodeId=bf3b202120087, content=<a href='/topic/show?id=0143456eae' target=_blank style='color:#2F92EE;'>#CHA2DS2-VASc评分#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4567, encryptionId=0143456eae, topicName=CHA2DS2-VASc评分)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d0b2500136, createdName=12498b08m90暂无昵称, createdTime=Mon Oct 21 09:16:00 CST 2019, time=2019-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1782922, encodeId=930f1e829226e, content=<a href='/topic/show?id=c1fa456550' target=_blank style='color:#2F92EE;'>#CHA2#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4565, encryptionId=c1fa456550, topicName=CHA2)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ca89104, createdName=huperzia, createdTime=Sun Dec 08 04:16:00 CST 2019, time=2019-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1503667, encodeId=6f79150366e3e, content=<a href='/topic/show?id=4f215634296' target=_blank style='color:#2F92EE;'>#持续时间#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56342, encryptionId=4f215634296, topicName=持续时间)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=13e29684821, createdName=zhwj, createdTime=Thu Oct 17 13:16:00 CST 2019, time=2019-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1573497, encodeId=88e615e349712, content=<a href='/topic/show?id=79b34566e1' target=_blank style='color:#2F92EE;'>#CHA2DS2-VASc#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4566, encryptionId=79b34566e1, topicName=CHA2DS2-VASc)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5f2615885776, createdName=canlab, createdTime=Thu Oct 17 13:16:00 CST 2019, time=2019-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1626918, encodeId=379e1626918e8, content=<a href='/topic/show?id=986a5101e46' target=_blank style='color:#2F92EE;'>#心房#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51017, encryptionId=986a5101e46, topicName=心房)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=20ba21064884, createdName=sodoo, createdTime=Thu Oct 17 13:16:00 CST 2019, time=2019-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026474, encodeId=3a2610264e458, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Wed Oct 16 01:16:00 CST 2019, time=2019-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=373969, encodeId=dcf83e3969d8, content=嘎, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIDxOgg5f7B6K0rAzK7WF7ib9XA558k2cZo8aIrNB3VJecibV52sP0xas5u4Eq4HYsMa1tZLShSaMtw/132, createdBy=d70e5209172, createdName=奔跑的小剑, createdTime=Wed Oct 16 00:06:19 CST 2019, time=2019-10-16, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1938999, encodeId=6bf0193899939, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Mon Dec 02 16:16:00 CST 2019, time=2019-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2021200, encodeId=bf3b202120087, content=<a href='/topic/show?id=0143456eae' target=_blank style='color:#2F92EE;'>#CHA2DS2-VASc评分#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4567, encryptionId=0143456eae, topicName=CHA2DS2-VASc评分)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d0b2500136, createdName=12498b08m90暂无昵称, createdTime=Mon Oct 21 09:16:00 CST 2019, time=2019-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1782922, encodeId=930f1e829226e, content=<a href='/topic/show?id=c1fa456550' target=_blank style='color:#2F92EE;'>#CHA2#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4565, encryptionId=c1fa456550, topicName=CHA2)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ca89104, createdName=huperzia, createdTime=Sun Dec 08 04:16:00 CST 2019, time=2019-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1503667, encodeId=6f79150366e3e, content=<a href='/topic/show?id=4f215634296' target=_blank style='color:#2F92EE;'>#持续时间#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56342, encryptionId=4f215634296, topicName=持续时间)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=13e29684821, createdName=zhwj, createdTime=Thu Oct 17 13:16:00 CST 2019, time=2019-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1573497, encodeId=88e615e349712, content=<a href='/topic/show?id=79b34566e1' target=_blank style='color:#2F92EE;'>#CHA2DS2-VASc#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4566, encryptionId=79b34566e1, topicName=CHA2DS2-VASc)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5f2615885776, createdName=canlab, createdTime=Thu Oct 17 13:16:00 CST 2019, time=2019-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1626918, encodeId=379e1626918e8, content=<a href='/topic/show?id=986a5101e46' target=_blank style='color:#2F92EE;'>#心房#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51017, encryptionId=986a5101e46, topicName=心房)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=20ba21064884, createdName=sodoo, createdTime=Thu Oct 17 13:16:00 CST 2019, time=2019-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026474, encodeId=3a2610264e458, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Wed Oct 16 01:16:00 CST 2019, time=2019-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=373969, encodeId=dcf83e3969d8, content=嘎, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIDxOgg5f7B6K0rAzK7WF7ib9XA558k2cZo8aIrNB3VJecibV52sP0xas5u4Eq4HYsMa1tZLShSaMtw/132, createdBy=d70e5209172, createdName=奔跑的小剑, createdTime=Wed Oct 16 00:06:19 CST 2019, time=2019-10-16, status=1, ipAttribution=)]
    2019-10-17 sodoo
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    2019-10-16 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

    0

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    2019-10-16 奔跑的小剑

    0

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