Why now? Moving from stroke risk factors to stroke triggers
Why now? Moving from stroke risk factors to stroke triggers
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DOI：
10.1097/wco.0b013e328012da75
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发表时间：
2007-02-01
影响因子：
4.8
通讯作者：
Elkind, Mitchell S. V.
中科院分区：
文献类型：
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作者：
Elkind, Mitchell S. V.
回顾的目的虽然中风的慢性危险因素是合理的理解，急性precipitants，或触发，中风，仍然相对understudied.Recent调查结果几个收敛线的证据表明，短暂的扰动全身代谢可能会引起心血管事件，包括中风的发作。流行病学数据，包括采用考虑不同时间段个体内差异的新设计的研究，已用于阐明心肌缺血的触发因素，这些方法已开始用于卒中研究。急性感染，特别是上呼吸道感染和其他炎症刺激已成为急性缺血性卒中的重要触发因素。所涉及的机制包括免疫介导的血小板活化和内皮功能障碍。似乎也有一段时间，或'中风倾向的状态'，其特征是弥漫性激活的血管系统，在此期间，患者可能会在初始和复发缺血events.Summary的风险增加，这些发现在进一步的研究中确认可能有助于阐明这种短期中风风险增加背后的机制。对这一高度敏感时期的评估方法的改进可能会导致更有时间针对性的预防干预。
Purpose of review While chronic risk factors for stroke are reasonably well understood, the acute precipitants, or triggers, of stroke, remain relatively understudied.Recent findings Several converging lines of evidence indicate that transient perturbations in systemic metabolism may provoke the onset of cardiovascular events, including stroke. Epidemiologic data, including studies utilizing novel designs that consider intraindividual differences across different time periods, have been used to clarify triggers for myocardial ischemia, and these methods are beginning to be employed in stroke research. Acute infections, particularly upper respiratory infections, and other inflammatory stimuli have emerged as important triggers of acute ischemic stroke. The mechanisms involved include immunologically mediated activation of platelets and endothelial dysfunction. There also appears to be a period of time, or 'stroke-prone state', characterized by diffuse activation of the vasculature during which patients may be at increased risk of initial and recurrent ischemic events.Summary Confirmation of these findings in further studies may help elucidate the mechanisms behind this short-term increase in stroke risk. Improved methods of assessment of this period of heightened susceptibility could lead to more temporally focused preventive interventions.