Frequency, predictors and cardiovascular outcomes associated with transthoracic echocardiographic findings during acute ischaemic stroke hospitalisation.
Frequency, predictors and cardiovascular outcomes associated with transthoracic echocardiographic findings during acute ischaemic stroke hospitalisation.
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DOI：
10.1136/svn-2021-001170
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发表时间：
2022-12
影响因子：
5.9
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中科院分区：
文献类型：
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目的探讨经胸超声心动图(TTE)在急性缺血性卒中(AIS)中的临床应用价值。在AIS住院期间获得TTE的效用尚不确定。我们研究了AIS在一个中心的住院情况(2002-2016)。TTE异常被归类为与以下相关的发现：高中风风险(I类)、心脏事件(II类)和意义不明(III类)。我们进行Logistic回归以预测I、II和III类异常。评估了ICD9和10编码作为I、II和III类异常的函数记录的1 年再发卒中住院的几率。对超过卒中危险因素的1 年复发性缺血性卒中住院的预测能力的改善通过净重新分类改善进行评估。有5523人因AIS住院。近81%的入院TTE异常(I类占18.7%，II类占32.7%，III类占72.8%)。患有冠状动脉疾病、房颤、高血压、糖尿病以及颅内外血管通畅的老年患者可能有异常的TTE。I类发现与卒中复发住院1年的几率较低相关(OR 0.54，95%CI 0.30至0.96)。I类数据显著改善了超过卒中危险因素的1年复发缺血性卒中住院的预测值(重新分类净改善0.1563，95%可信区间0.0465至0.2661)。在AIS住院期间，与中风和心脏事件风险相关的TTE异常通常被检测到。检测到I类TTE发现降低了中风复发的风险，这可能是由于靶向治疗中和了心源性栓塞源，表明了TTE的临床效用。
To characterise the clinical utility of transthoracic echocardiography (TTE) at the time of acute ischaemic stroke (AIS). The utility of obtaining a TTE during AIS hospitalisation is uncertain. We studied AIS hospitalisations at a single centre (2002–2016). TTE abnormalities were classified as findings associated with: high stroke risk (Category I), cardiac events (Category II) and of unclear significance (Category III). We performed logistic regressions to predict Category I, II and III abnormalities. The odds of 1 year recurrent stroke hospitalisation captured by ICD 9 and 10 codes as a function of Category I, II and III abnormalities were assessed. Improvement in predictive capacity for 1 year recurrent ischaemic stroke hospitalisation beyond stroke risk factors was evaluated by net reclassification improvement. There were 5523 AIS hospitalisations. Nearly 81% of admission TTEs were abnormal (18.7% Category I, 32.7% Category II, 72.8% Category III). Older patients with coronary artery disease, atrial fibrillation, hypertension, diabetes, and patent intracranial and extracranial vessels were likely to have an abnormal TTE. Category I finding was associated with lower odds of 1-year recurrent stroke hospitalisation (OR 0.54, 95% CI 0.30 to 0.96). Category I data significantly improved the predictive value for 1-year recurrent ischaemic stroke hospitalisation beyond stroke risk factors (net reclassification improvement 0.1563, 95% CI 0.0465 to 0.2661). TTE abnormalities associated with stroke and cardiac event risk were commonly detected during AIS hospitalisation. Detection of Category I TTE findings reduced the risk of recurrent stroke, potentially due to neutralisation of the cardioembolic source by targeted therapy, indicating the clinical utility of TTE.
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影响因子：
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作者：
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