Spectrum of Cerebrovascular Disease in Patients with Multiple Myeloma Undergoing Chemotherapy-Results of a Case Control Study.
Spectrum of Cerebrovascular Disease in Patients with Multiple Myeloma Undergoing Chemotherapy-Results of a Case Control Study.
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DOI：
10.1371/journal.pone.0166627
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Waheed S
中科院分区：
文献类型：
--
作者：
Hinduja A;Limaye K;Ravilla R;Sasapu A;Papanikolaou X;Wei L;Torbey M;Waheed S
多发性骨髓瘤 (MM) 患者发生动脉血栓的风险增加。我们的目的是确定这些患者中风的危险因素、机制和结果。我们对 1998 年 10 月至 2014 年 1 月期间出现血管事件（短暂性脑缺血发作、缺血性中风或脑出血）的 MM 患者数据库进行了一项回顾性匹配病例对照研究。将病例的基线人口统计数据、危险因素、MM 特征、实验室值和死亡率与对照组进行比较。多变量逻辑回归分析确定了与中风相关的危险因素。缺血性中风 (IS) 采用修订后的 Org 10172 急性中风治疗 (TOAST) 标准试验标准进行分类。在 1,148 名患者中，46 名患者出现血管事件（缺血性中风，33 名；短暂性脑缺血发作，11 名；高血压脑出血，2 名）。多变量逻辑回归分析确定肾功能不全（比值比，3.528；95% CI，1.36-9.14；P = 0.0094）和 MM I 期和 II 期（比值比，2.770，95% CI，1.31-5.81；p = 0.0073）是卒中的独立预测因子。在我们的研究中，高凝状态、心房颤动和小血管闭塞导致的中风是常见机制。中风后，78% 的患者出院回家或康复机构，4% 前往长期护理机构；院内死亡率为 15%。尽管患有中风，但没有观察到生存率存在显着差异。在我们的多发性骨髓瘤患者队列中，肾功能衰竭和 MM I 期和 II 期会增加中风风险。
Patients with multiple myeloma (MM) are at increased risk of arterial thrombosis. Our aim was to determine the risk factors, mechanisms and outcome of strokes in these patients. We conducted a retrospective matched case–control study from our database of MM patients enrolled in Total Therapy (TT) 2, TT3a and TT3b protocols who developed a vascular event (transient ischemic attack, ischemic stroke, or intracerebral hemorrhage) from October 1998 to January 2014. Cases were matched for age-matched selected controls. Baseline demographics, risk factors, MM characteristics, laboratory values, and mortality of cases were compared to those of controls. Multivariate logistic regression analysis identified risk factors associated with stroke. Ischemic strokes (IS) were classified with modified Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria. Of 1,148 patients, 46 developed a vascular event (ischemic stroke, 33; transient ischemic attack, 11; hypertensive intracerebral hemorrhage, 2). Multivariate logistic regression analysis determined renal insufficiency (odds Ratio, 3.528; 95% CI, 1.36–9.14; P = 0.0094) and MM Stages I and II (odds Ratio, 2.770, 95% CI, 1.31–5.81; p = 0.0073) were independent predictors of stroke. In our study, strokes attributable to hypercoagulability, atrial fibrillation and small-vessel occlusion were common mechanisms. After a stroke, 78% of patients were discharged to home or a rehabilitation facility and 4% to a long-term nursing facility; in-hospital mortality was 15%. Despite suffering a stroke no significant differences in survival were observed. In our cohort of multiple myeloma patients, renal failure and MM Stages I and II had increased risk of stroke.
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尽管肾功能改善了新诊断的多发性骨髓瘤，但肾功能不全仍保留了不良预后的影响。
影响因子：
11.4
作者：
通讯作者：
--
DOI：
10.1016/j.jstrokecerebrovasdis.2012.06.005
发表时间：
2014-01
影响因子：
2.5
作者：
Khatri, Minesh;Himmelfarb, Jonathan;Adams, Derk;Becker, Kyra;Longstreth, W. T.;Tirschwell, David L.
通讯作者：
Tirschwell, David L.
影响因子：
37.8
作者：
Hong KS;Yegiaian S;Lee M;Lee J;Saver JL
通讯作者：
Saver JL
DOI：
10.3324/haematol.2012.064444
发表时间：
2012-10-01
期刊：
HAEMATOLOGICA-THE HEMATOLOGY JOURNAL
影响因子：
--
作者：
Kristinsson, Sigurdur Y.;Pfeiffer, Ruth M.;Landgren, Ola
通讯作者：
Landgren, Ola
影响因子：
8.3
作者：
Ikram, M. Arfan;Vernooij, Meike W.;Breteler, Monique M. B.
通讯作者：
Breteler, Monique M. B.