Cognitive Impairment after Lacunar Stroke and the Risk of Recurrent Stroke and Death.
Cognitive Impairment after Lacunar Stroke and the Risk of Recurrent Stroke and Death.
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DOI：
10.1159/000514261
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
SPS3 Study Group
中科院分区：
文献类型：
--
作者：
Kwan A;Wei J;Dowling NM;Power MC;Nadareishvili Z;SPS3 Study Group
中风后认知障碍的患者似乎有更高的中风复发和死亡风险。然而，腔隙性卒中后的认知损害是否与复发性卒中和死亡有关仍不清楚。我们评估了腔隙性卒中后的全局性或特定领域的认知损害是否与复发性卒中和死亡有关。我们考虑了二级预防小脑皮质下卒中(SPS3)试验的患者，在合格的腔隙性卒中后14到180天，由SPS3认证的人员用英语进行基线认知测试。我们考虑了认知评估筛查工具上的基线分数≤86来指示整体认知损害，时钟上的<；10来指示执行功能损害，以及特定领域的总结分数在最低四分位中的分数来指示记忆和非记忆损害。我们使用COX比例风险模型来估计卒中后认知损害与随后复发卒中和死亡风险之间的关系。这项研究包括1528名参与者，他们在符合条件的中风后62天登记的中位数时间。在平均3.9年的随访中，11.4%的参与者中风复发，8.2%的人死亡。在完全调整的模型中，记忆障碍与中风复发风险(风险比，1.48；95%可信区间[95%CI]，1.04-2.09)和死亡(风险比，1.87；95%可信区间，1.25-2.79)独立相关。整体损害(危险比，1.66；95%可信区间，1.06-2.59)和非记忆损害(危险比，1.74；95%可信区间，1.14-2.67)与死亡风险增加相关。腔隙性卒中后，记忆损害是复发卒中和死亡的独立预测因素，而整体和非记忆损害与死亡有关。腔隙性卒中的认知筛查可能有助于识别中风复发和死亡风险较高的人群。
Patients with post-stroke cognitive impairment appear to be at higher risk of recurrent stroke and death. However, whether cognitive impairment after lacunar stroke is associated with recurrent stroke and death remains unclear. We assessed whether global or domain-specific cognitive impairment after lacunar stroke is associated with recurrent stroke and death. We considered patients from the Secondary Prevention of Small Subcortical Strokes (SPS3) trial with a baseline cognitive exam administered in English by certified SPS3 personnel, 14 to 180 days after qualifying lacunar stroke. We considered a baseline score of ≤ 86 on the Cognitive Assessment Screening Instrument to indicate global cognitive impairment, <10 on the Clock Drawing on Command test to indicate executive function impairment, and domain-specific summary scores in the lowest quartile to indicate memory and non-memory impairment. We used Cox proportional hazards models to estimate the association between post-stroke cognitive impairment and subsequent risk of recurrent stroke and death. The study included 1,528 participants with a median enrollment time 62 days after qualifying stroke. During a mean follow-up of 3.9 years, 11.4% of participants had recurrent stroke and 8.2% died. In the fully adjusted models, memory impairment was independently associated with an increased risk of recurrent stroke (hazard ratio, 1.48; 95% confidence interval [95% CI], 1.04 – 2.09) and death (hazard ratio, 1.87; 95% CI, 1.25 – 2.79). Global impairment (hazard ratio, 1.66; 95% CI, 1.06 – 2.59) and non-memory impairment (hazard ratio, 1.74; 95% CI, 1.14 – 2.67) were associated with an increased risk of death. After lacunar stroke, memory impairment was an independent predictor of recurrent stroke and death, while global and non-memory impairment were associated with death. Cognitive screening in lacunar stroke may help identify populations at higher risk of recurrent stroke and death.
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影响因子：
11.2
作者：
Jacova, Claudia;Pearce, Lesly A.;Costello, Raymond;McClure, Leslie A.;Holliday, Stephen L.;Hart, Robert G.;Benavente, Oscar R.
通讯作者：
Benavente, Oscar R.
影响因子：
8.3
作者：
Narasimhalu, Kaavya;Ang, Sandy;Chen, Christopher P.
通讯作者：
Chen, Christopher P.
在小型皮层中风试验的二级预防中，微孔虫：中风，死亡率和治疗相互作用。
影响因子：
11.2
作者：
Shoamanesh A;Pearce LA;Bazan C;Catanese L;McClure LA;Sharma M;Marti-Fabregas J;Anderson DC;Kase CS;Hart RG;Benavente OR;SPS3 Trial Investigators
通讯作者：
SPS3 Trial Investigators
影响因子：
11
作者：
Sibolt, Gerli;Curtze, Sami;Erkinjuntti, Timo
通讯作者：
Erkinjuntti, Timo
DOI：
10.1056/nejmoa1204133
发表时间：
2012-08-30
期刊：
The New England journal of medicine
影响因子：
--
作者：
SPS3 Investigators;Benavente OR;Hart RG;McClure LA;Szychowski JM;Coffey CS;Pearce LA
通讯作者：
Pearce LA