JAHA:先天性心脏病成年患者缺血性卒中及死亡风险显著增加

2019-07-26 国际循环编辑部 国际循环

先天性心脏病与包括心律失常和心力衰竭在内的缺血性卒中危险因素具有相关性,但目前缺少关于心脏病成年患者缺血性卒中相关危险因素和死亡率的长期随访数据。近期,发表于《美国心脏协会杂志》(Journal of the American Heart Association)一篇队列研究对此进行分析。

先天性心脏病与包括心律失常和心力衰竭在内的缺血性卒中危险因素具有相关性,但目前缺少关于心脏病成年患者缺血性卒中相关危险因素和死亡率的长期随访数据。近期,发表于《美国心脏协会杂志》(Journal of the American Heart Association)一篇队列研究对此进行分析。

研究以丹麦全国登记的人口数据为基础,筛选其中年龄≥18岁、1963年至2017年任何年龄段的先天性心脏病患者,按性别与出生年份匹配(1:10)建立普通人口比较队列,对患者按照年龄<60岁(年轻)和≥60岁(年长)分类,计算不同年龄先天性心脏病成人患者缺血性卒中及卒中发作后30天死亡率的调整风险比(AHR)。最终,研究共纳入16 836例先天性心脏病成年患者。比较缺血性卒中的总体发作情况,先天性心脏病组60岁时缺血性卒中风险为7.4%,普通人群为2.9%。与普通人群相比,年轻先天性心脏病患者缺血性中风的AHR=3.8 (95%CI:3.3~4.3),年长先天性心脏病患者AHR=1.6 (95%CI: 1.4~1.9)。与普通人群相比,年轻先天性心脏病患者卒中后死亡率的AHR=2.3 (95%CI:1.2~4.4),年长先天性心脏病患者为1.3 (95%CI:0.9~1.9)。

无论是年轻的还是年长,先天性心脏病患者缺血性卒中风险较常人均显著增加。60岁时,先天性心脏病患者的缺血性卒中风险达7.4%。与普通人群相比,先天性心脏病成年患者卒中后30天内死亡率也显著增加。

原始出处:
Mette Glavind Bülow Pedersen, Morten S. Olsen, et al. Ischemic Stroke in Adults With Congenital Heart Disease: A Population‐Based Cohort Study. Journal of the American Heart Association. Originally published 18 Jul 2019.

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    2019-07-30 thm112988

    0

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  5. [GetPortalCommentsPageByObjectIdResponse(id=1893194, encodeId=33e41893194d2, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Sun Dec 01 20:35:00 CST 2019, time=2019-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806338, encodeId=fc4c1806338d6, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Thu Oct 24 00:35:00 CST 2019, time=2019-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=370490, encodeId=6e7b3e0490b9, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bbc11488193, createdName=thm112988, createdTime=Tue Jul 30 07:45:05 CST 2019, time=2019-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1255887, encodeId=7958125588e62, content=<a href='/topic/show?id=587f6339050' target=_blank style='color:#2F92EE;'>#死亡风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63390, encryptionId=587f6339050, topicName=死亡风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Sun Jul 28 13:35:00 CST 2019, time=2019-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1268185, encodeId=ab50126818524, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Sun Jul 28 13:35:00 CST 2019, time=2019-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1369461, encodeId=a5661369461a7, content=<a href='/topic/show?id=bc9f28589d0' target=_blank style='color:#2F92EE;'>#先天性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28589, encryptionId=bc9f28589d0, topicName=先天性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a435298, createdName=huirong, createdTime=Sun Jul 28 13:35:00 CST 2019, time=2019-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026418, encodeId=e06810264182a, 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=Sat Jul 27 01:35:00 CST 2019, time=2019-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=370312, encodeId=a7ba3e031264, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Fri Jul 26 23:20:50 CST 2019, time=2019-07-26, status=1, ipAttribution=)]
    2019-07-28 zhaohui6731
  6. [GetPortalCommentsPageByObjectIdResponse(id=1893194, encodeId=33e41893194d2, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Sun Dec 01 20:35:00 CST 2019, time=2019-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806338, encodeId=fc4c1806338d6, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Thu Oct 24 00:35:00 CST 2019, time=2019-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=370490, encodeId=6e7b3e0490b9, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bbc11488193, createdName=thm112988, createdTime=Tue Jul 30 07:45:05 CST 2019, time=2019-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1255887, encodeId=7958125588e62, content=<a href='/topic/show?id=587f6339050' target=_blank style='color:#2F92EE;'>#死亡风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63390, encryptionId=587f6339050, topicName=死亡风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Sun Jul 28 13:35:00 CST 2019, time=2019-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1268185, encodeId=ab50126818524, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Sun Jul 28 13:35:00 CST 2019, time=2019-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1369461, encodeId=a5661369461a7, content=<a href='/topic/show?id=bc9f28589d0' target=_blank style='color:#2F92EE;'>#先天性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28589, encryptionId=bc9f28589d0, topicName=先天性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a435298, createdName=huirong, createdTime=Sun Jul 28 13:35:00 CST 2019, time=2019-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026418, encodeId=e06810264182a, 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=Sat Jul 27 01:35:00 CST 2019, time=2019-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=370312, encodeId=a7ba3e031264, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Fri Jul 26 23:20:50 CST 2019, time=2019-07-26, status=1, ipAttribution=)]
    2019-07-28 huirong
  7. [GetPortalCommentsPageByObjectIdResponse(id=1893194, encodeId=33e41893194d2, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Sun Dec 01 20:35:00 CST 2019, time=2019-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806338, encodeId=fc4c1806338d6, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Thu Oct 24 00:35:00 CST 2019, time=2019-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=370490, encodeId=6e7b3e0490b9, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bbc11488193, createdName=thm112988, createdTime=Tue Jul 30 07:45:05 CST 2019, time=2019-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1255887, encodeId=7958125588e62, content=<a href='/topic/show?id=587f6339050' target=_blank style='color:#2F92EE;'>#死亡风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63390, encryptionId=587f6339050, topicName=死亡风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Sun Jul 28 13:35:00 CST 2019, time=2019-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1268185, encodeId=ab50126818524, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Sun Jul 28 13:35:00 CST 2019, time=2019-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1369461, encodeId=a5661369461a7, content=<a href='/topic/show?id=bc9f28589d0' target=_blank style='color:#2F92EE;'>#先天性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28589, encryptionId=bc9f28589d0, topicName=先天性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a435298, createdName=huirong, createdTime=Sun Jul 28 13:35:00 CST 2019, time=2019-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026418, encodeId=e06810264182a, 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=Sat Jul 27 01:35:00 CST 2019, time=2019-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=370312, encodeId=a7ba3e031264, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Fri Jul 26 23:20:50 CST 2019, time=2019-07-26, status=1, ipAttribution=)]
    2019-07-27 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

  8. [GetPortalCommentsPageByObjectIdResponse(id=1893194, encodeId=33e41893194d2, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Sun Dec 01 20:35:00 CST 2019, time=2019-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806338, encodeId=fc4c1806338d6, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Thu Oct 24 00:35:00 CST 2019, time=2019-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=370490, encodeId=6e7b3e0490b9, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bbc11488193, createdName=thm112988, createdTime=Tue Jul 30 07:45:05 CST 2019, time=2019-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1255887, encodeId=7958125588e62, content=<a href='/topic/show?id=587f6339050' target=_blank style='color:#2F92EE;'>#死亡风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63390, encryptionId=587f6339050, topicName=死亡风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Sun Jul 28 13:35:00 CST 2019, time=2019-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1268185, encodeId=ab50126818524, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Sun Jul 28 13:35:00 CST 2019, time=2019-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1369461, encodeId=a5661369461a7, content=<a href='/topic/show?id=bc9f28589d0' target=_blank style='color:#2F92EE;'>#先天性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28589, encryptionId=bc9f28589d0, topicName=先天性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a435298, createdName=huirong, createdTime=Sun Jul 28 13:35:00 CST 2019, time=2019-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026418, encodeId=e06810264182a, 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=Sat Jul 27 01:35:00 CST 2019, time=2019-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=370312, encodeId=a7ba3e031264, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Fri Jul 26 23:20:50 CST 2019, time=2019-07-26, status=1, ipAttribution=)]
    2019-07-26 天地飞扬

    学习

    0

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Lancet:产前3D-MRI用于胎儿先天性心脏病的诊断

研究认为,利用图像处理软件进行标准胎儿MRI,所形成的血管高分辨率3D成像可提高胎儿先天性心脏病诊断的准确性

Eur Heart J:MELODY登记的急性和中期结局:经导管肺动脉瓣植入的多中心登记

批准后的MELODY登记证实了在一个大型CHD患者队列中使用Melody™瓣膜进行TPVI的疗效。

JCLA:一名4岁患有先天性心脏病和发育不良的男孩的嵌合三体—病例报告

22三体嵌合是一种罕见的可存活的常染色体异常病变。在遗传咨询过程中,从嵌合体中识别出与生命不相容的完整的22三体至关重要。受影响的镶嵌病例临床表现包括,蹼状颈,发育迟缓,异常的耳朵,心脏疾病和小头畸形。这些患者的表型比全染色体非整倍体较为温和,其严重程度取决于三体细胞的数量。在此,研究人员我们描述了一名来自健康的父母且没有任何遗传疾病的家族史的4岁男孩病例报道。 患者出现面部不对称、腭裂、胃

EClinical Medicine:中东地区先天性心脏病患儿治疗研究

研究结果表明,与以色列患者相比,巴勒斯坦先心病患者接受治疗更晚,后续治疗更差

Int J Cardiol:先天性心脏病手术患儿B型利钠肽前体N末端水平的变化及临床预后

由此可见,升高的NT-proBNP可能是接受心脏手术的冠心病患儿不良预后的有用标志。