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Stroke：冠状动脉钙化为卒中独立预测因子

2013-03-05 高晓方 译 医学论坛网

冠状动脉钙化卒中独立预测因子
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  　　德国学者的一项研究表明，在中、低血管风险个体中，冠状动脉钙化（CAC）为经典危险因素之外的卒中独立预测因子。论文于2013年2月28日在线发表于《卒中》（Stroke）。 　　此项研究从基于人群的Heinz Nixdorf Recall研究中纳入4180例受试者。受试者既往无卒中、冠心病或心肌梗死病史，并就卒中事件接受94.9±19.4月的随访评估。利用C

冠状动脉钙化
 

　　德国学者的一项研究表明，在中、低血管风险个体中，冠状动脉钙化（CAC）为经典危险因素之外的卒中独立预测因子。论文于2013年2月28日在线发表于《卒中》（Stroke）。

　　此项研究从基于人群的Heinz Nixdorf Recall研究中纳入4180例受试者。受试者既往无卒中、冠心病或心肌梗死病史，并就卒中事件接受94.9±19.4月的随访评估。利用Cox比例风险回归评估CAC对卒中的预测作用。

　　结果显示，随访期间共出现92例偶发性卒中（缺血性82例，出血性10例）。卒中患者的基线CAC值显著高于其他受试者（P<0.001）。在多变量Cox回归分析中，除年龄、收缩压和吸烟之外，log10（CAC+1）为卒中的独立预测因子（危险比[HR] 1.52；P=0.001）。在男性和女性中CAC均可预测卒中，在年龄小于65岁并且无房颤受试者中尤为如此。在Framingham风险评分中、低分类受试者中，CAC可特异性区分卒中风险。

与卒中相关的拓展阅读：


Coronary Artery Calcification Is an Independent Stroke Predictor in the General Population

Background and Purpose
Coronary artery calcification (CAC) is a noninvasive marker of plaque load that predicts myocardial infarcts in the general population. Herein, we investigated whether CAC predicts stroke events in addition to established risk factors that are part of the Framingham risk score.
Methods
A total of 4180 subjects from the population-based Heinz Nixdorf Recall study (45–75 years of age; 47.1% men) without previous stroke, coronary heart disease, or myocardial infarction were evaluated for stroke events over 94.9±19.4 months. Cox proportional hazards regressions were used to examine CAC as stroke predictor in addition to established vascular risk factors (age, sex, systolic blood pressure, low-density lipoprotein, high-density lipoprotein, diabetes mellitus, smoking, and atrial fibrillation).
Results
Ninety-two incident strokes occurred (82 ischemic, 10 hemorrhagic). Subjects suffering a stroke had significantly higher CAC values at baseline than the remaining subjects (median, 104.8[Q1;Q3, 14.0;482.2] vs 11.2[0;106.2]; P<0.001). In a multivariable Cox regression, log10(CAC+1) was an independent stroke predictor (hazards ratio, 1.52 [95% confidence interval, 1.19–1.92]; P=0.001) in addition to age (1.35 per 5 years [1.15–1.59]; P<0.001), systolic blood pressure (1.25 per 10 mm Hg [1.14–1.37]; P<0.001), and smoking (1.75 [1.07–2.87]; P=0.025). CAC predicted stroke in men and women, particularly in subjects <65 years of age and independent of atrial fibrillation. CAC discriminated stroke risk specifically in participants belonging to the low (<10%) and intermediate (10%–20%) Framingham risk score categories.
Conclusions
CAC is an independent stroke predictor in addition to classical risk factors in subjects at low or intermediate vascular risk.

    

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    2013-11-19 夏天与十三菇凉

    #冠状动脉钙#

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    2013-06-17 1249897bm45(暂无昵称)

    #动脉钙化#

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    2013-03-07 shizhenshan

    #冠状动脉钙化#

    0

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    2013-03-07 宋威

    #预测因子#

    0

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