JACC:心梗伴心衰患者如何评估卒中发生风险?

2018-02-23 MedSci MedSci原创

不伴有房颤的心梗患者也会有发生卒中的风险。本研究的目的旨在探索出一套评估心梗伴心衰和/或收缩功能不全患者卒中发生风险的评分体系。本研究纳入了来自4个临床试验的22904名无房颤的心梗患者,主要终点事件是卒中,死亡视为竞争危险因素。经过平均1.9年时间的随访,有660名(2.9%)患者出现了卒中,这些患者的年龄更大,女性更常见,并且更容易抽烟和高血压,另外,这些患者的肾小球滤过率更低,有心梗、心衰、

不伴有房颤的心梗患者也会有发生卒中的风险。本研究的目的旨在探索出一套评估心梗伴心衰和/或收缩功能不全患者卒中发生风险的评分体系。

本研究纳入了来自4个临床试验的22904名无房颤的心梗患者,主要终点事件是卒中,死亡视为竞争危险因素。经过平均1.9年时间的随访,有660名(2.9%)患者出现了卒中,这些患者的年龄更大,女性更常见,并且更容易抽烟和高血压,另外,这些患者的肾小球滤过率更低,有心梗、心衰、糖尿病和卒中疾病史的比例更高。最终,评分系统里保留了以下危险因素:高龄,Killip分级3或4级,肾小球滤过率≤45 ml/min/1.73 m2,高血压和卒中疾病史。该模型已经校准,并且具备较好的辨识度(C-index = 0.67)。

本研究探索出了一套能较准确评估心梗伴心衰患者发生卒中发生风险的评分体系,包括高龄,Killip分级3或4级,肾小球滤过率≤45 ml/min/1.73 m2,高血压和卒中疾病史。

原始出处:

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    2018-12-19 hbwxf
  2. 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    2018-05-02 jyzxjiangqin

    心梗伴心衰患者评估.

    0

  3. 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    2018-04-22 jyzxjiangqin

    心梗伴心衰患者评估.

    0

  4. 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2018, time=2018-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=300440, encodeId=033e3004405d, content=心梗伴心衰患者如何评估., beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Mar 28 07:16:57 CST 2018, time=2018-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296690, encodeId=05d32966904b, content=心梗伴心衰患者如何评估., beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Fri Mar 16 07:15:01 CST 2018, time=2018-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=292432, encodeId=888629243203, content=心梗伴心衰风险更大., beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sat Mar 03 06:43:15 CST 2018, time=2018-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325710, encodeId=50261325e10c2, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sun Feb 25 12:00:00 CST 2018, time=2018-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1373396, encodeId=425113e339626, content=<a href='/topic/show?id=2fd051939ab' target=_blank style='color:#2F92EE;'>#心衰患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51939, encryptionId=2fd051939ab, topicName=心衰患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=智者为医08, createdTime=Sun Feb 25 12:00:00 CST 2018, time=2018-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=290404, encodeId=233929040477, content=心梗伴心衰发生卒中风险., beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sat Feb 24 07:17:15 CST 2018, time=2018-02-24, status=1, ipAttribution=)]
    2018-04-10 jyzxjiangqin

    心梗伴心衰患者如何评估.

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1853942, encodeId=607118539420c, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Wed Dec 19 00:00:00 CST 2018, time=2018-12-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311215, encodeId=671a311215d0, content=心梗伴心衰患者评估., beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed May 02 07:34:52 CST 2018, time=2018-05-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=308127, encodeId=c53230812ede, content=心梗伴心衰患者评估., beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sun Apr 22 07:30:45 CST 2018, time=2018-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=304403, encodeId=4c2c304403db, content=心梗伴心衰患者如何评估., beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Apr 10 07:22:27 CST 2018, time=2018-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=300440, encodeId=033e3004405d, content=心梗伴心衰患者如何评估., beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Mar 28 07:16:57 CST 2018, time=2018-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296690, encodeId=05d32966904b, content=心梗伴心衰患者如何评估., beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Fri Mar 16 07:15:01 CST 2018, time=2018-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=292432, encodeId=888629243203, content=心梗伴心衰风险更大., beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sat Mar 03 06:43:15 CST 2018, time=2018-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325710, encodeId=50261325e10c2, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sun Feb 25 12:00:00 CST 2018, time=2018-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1373396, encodeId=425113e339626, content=<a href='/topic/show?id=2fd051939ab' target=_blank style='color:#2F92EE;'>#心衰患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51939, encryptionId=2fd051939ab, topicName=心衰患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=智者为医08, createdTime=Sun Feb 25 12:00:00 CST 2018, time=2018-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=290404, encodeId=233929040477, content=心梗伴心衰发生卒中风险., beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sat Feb 24 07:17:15 CST 2018, time=2018-02-24, status=1, ipAttribution=)]
    2018-03-28 jyzxjiangqin

    心梗伴心衰患者如何评估.

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1853942, encodeId=607118539420c, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Wed Dec 19 00:00:00 CST 2018, time=2018-12-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311215, encodeId=671a311215d0, content=心梗伴心衰患者评估., beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed May 02 07:34:52 CST 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2018, time=2018-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=300440, encodeId=033e3004405d, content=心梗伴心衰患者如何评估., beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Mar 28 07:16:57 CST 2018, time=2018-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296690, encodeId=05d32966904b, content=心梗伴心衰患者如何评估., beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Fri Mar 16 07:15:01 CST 2018, time=2018-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=292432, encodeId=888629243203, content=心梗伴心衰风险更大., beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sat Mar 03 06:43:15 CST 2018, time=2018-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325710, encodeId=50261325e10c2, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sun Feb 25 12:00:00 CST 2018, time=2018-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1373396, encodeId=425113e339626, content=<a href='/topic/show?id=2fd051939ab' target=_blank style='color:#2F92EE;'>#心衰患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51939, encryptionId=2fd051939ab, topicName=心衰患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=智者为医08, createdTime=Sun Feb 25 12:00:00 CST 2018, time=2018-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=290404, encodeId=233929040477, content=心梗伴心衰发生卒中风险., beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sat Feb 24 07:17:15 CST 2018, time=2018-02-24, status=1, ipAttribution=)]
    2018-03-16 jyzxjiangqin

    心梗伴心衰患者如何评估.

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1853942, encodeId=607118539420c, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Wed Dec 19 00:00:00 CST 2018, time=2018-12-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311215, encodeId=671a311215d0, content=心梗伴心衰患者评估., beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed May 02 07:34:52 CST 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2018, time=2018-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=300440, encodeId=033e3004405d, content=心梗伴心衰患者如何评估., beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Mar 28 07:16:57 CST 2018, time=2018-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296690, encodeId=05d32966904b, content=心梗伴心衰患者如何评估., beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Fri Mar 16 07:15:01 CST 2018, time=2018-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=292432, encodeId=888629243203, content=心梗伴心衰风险更大., beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sat Mar 03 06:43:15 CST 2018, time=2018-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325710, encodeId=50261325e10c2, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sun Feb 25 12:00:00 CST 2018, time=2018-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1373396, encodeId=425113e339626, content=<a href='/topic/show?id=2fd051939ab' target=_blank style='color:#2F92EE;'>#心衰患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51939, encryptionId=2fd051939ab, topicName=心衰患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=智者为医08, createdTime=Sun Feb 25 12:00:00 CST 2018, time=2018-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=290404, encodeId=233929040477, content=心梗伴心衰发生卒中风险., beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sat Feb 24 07:17:15 CST 2018, time=2018-02-24, status=1, ipAttribution=)]
    2018-03-03 jyzxjiangqin

    心梗伴心衰风险更大.

    0

  8. 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    2018-02-24 jyzxjiangqin

    心梗伴心衰发生卒中风险.

    0

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