JAHA:急性失代偿性心衰患者缺血性卒中

2021-10-24 MedSci原创 MedSci原创

在ADHF住院期间,1.6%的患者发生缺血性卒中。男性、ACS、既往心衰住院和入院时高BNP/NT-proBNP水平与缺血性卒中独立相关。

心力衰竭(HF)是缺血性卒中已知的危险因素,但关于急性失代偿性HF(ADHF)住院期间缺血性卒中的数据十分有限。

近日,血管疾病领域权威杂志JAHA上发表了一篇研究文章,研究人员分析了多中心登记处(京都充血性心力衰竭[KCHF]登记处)的数据,该登记处在日本连续招​​募了4056名ADHF患者(平均年龄为78岁;2238名患者[55%]为男性;239名[5.9%]急性冠状动脉综合征[ACS]患者)。研究人员调查了ADHF住院期间缺血性卒中的发生率和预测因素。

在住院期间,63名(1.6%)患者发生了缺血性卒中。从入院到缺血性卒中发作的中位间隔为7[四分位距:2-14]天,最常见的潜在原因是心源性栓塞(64%)。

男性(OR为1.87;95%CI为1.11-3.24)、ACS(OR为2.31;95%CI为1.01-4.93)、既往没有因心衰住院(OR为2.21;95%CI为1.24-4.21)以及入院时高B型利钠肽(BNP)/BNP前体N末端(NT-proBNP)水平(高于中位数)(OR为3.15;95%CI为1.84-5.60)与缺血性卒中独立相关。在没有ACS的患者中,缺血性卒中的独立危险因素与主要分析中的完全一致。BNP/NT-proBNP水平较高四分位数与较高的缺血性卒中发生率显著相关(趋势P<0.001)。缺血性卒中患者的住院死亡率较高,住院时间较长,出院时功能状态较差。

由此可见,在ADHF住院期间,1.6%的患者发生缺血性卒中。男性、ACS、既往心衰住院和入院时高BNP/NT-proBNP水平与缺血性卒中独立相关。

原始出处:

Moritake Iguchi.et al.Ischemic Stroke in Acute Decompensated Heart Failure: From the KCHF Registry.JAHA.2021.https://www.ahajournals.org/doi/10.1161/JAHA.121.022525

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    2021-10-26 zhaohui6731
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    2021-10-24 ms5000000518166734

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