A Novel Risk Stratification System for Ischemic Stroke in Japanese Patients With Non-Valvular Atrial Fibrillation
A Novel Risk Stratification System for Ischemic Stroke in Japanese Patients With Non-Valvular Atrial Fibrillation
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DOI：
10.1253/circj.cj-20-1075
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发表时间：
2021-08-01
影响因子：
3.3
通讯作者：
Sasahara, Yusuke
中科院分区：
文献类型：
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作者：
Okumura, Ken;Tomita, Hirofumi;Sasahara, Yusuke
背景资料：最近，日本非瓣膜性房颤（NVAF）患者缺血性卒中的独立危险因素的识别是通过分析5个主要的日本注册：J-RHYTHM注册，伏见AF注册，新健数据库，庆应医院间心血管研究，和北陆加AF Registry.Methods和结果：在日本NVAF患者的风险计划的预测价值进行了评估。在16，918例患者中，分析了12，289例NVAF患者（平均随访时间为649 ± 181天）。采用校正的Cox风险比例分析确定每个显著独立风险因素的风险比（HR）。对HR进行数学变换，建立缺血性脑卒中评分系统，用c-统计量进行估计。在21，820人年随访期间，发生了241例缺血性卒中事件。重要的风险因素包括：老年人（年龄75-84岁[E]，HR=1.74）、极老年人（>= 85岁[EE]，HR=2.41）、高血压（H，HR=1.60）、既往卒中（S，HR=2.75）、AF类型（持续性/永久性）（T，HR=1.59）和低体重指数
Background: Recently, identification of independent risk factors for ischemic stroke in Japanese non-valvular atrial fibrillation (NVAF) patients was made by analyzing the 5 major Japanese registries: J-RHYTHM Registry, Fushimi AF Registry, Shinken Database, Keio interhospital Cardiovascular Studies, and the Hokuriku-Plus AF Registry.Methods and Results: The predictive value of the risk scheme in Japanese NVAF patients was assessed. Of 16,918 patients, 12,289 NVAF patients were analyzed (mean follow up, 649 +/- 181 days). Hazard ratios (HRs) of each significant, independent risk factor were determined by using adjusted Cox-hazard proportional analysis. Scoring system for ischemic stroke was created by transforming HR logarithmically and was estimated by c-statistic. During the 21,820 person-years follow up, 241 ischemic stroke events occurred. Significant risk factors were: being elderly (aged 75-84 years [E], HR=1.74), extreme elderly (>= 85 years [EE], HR=2.41), having hypertension (H, HR=1.60), previous stroke (S, HR=2.75), type of AF (persistent/permanent) (T, HR=1.59), and low body mass index