Comparing risks of death and recurrent vascular events between lacunar and non-lacunar infarction.
Comparing risks of death and recurrent vascular events between lacunar and non-lacunar infarction.
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比较lacunar和非lacunar梗死之间的死亡风险和复发性血管事件。
DOI：
10.1093/brain/awh636
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发表时间：
2005-11
期刊：
影响因子：
14.5
通讯作者：
Sudlow, C
中科院分区：
文献类型：
--
作者：
Jackson, C;Sudlow, C
腔隙性和非腔隙性脑梗死患者预后的差异可能支持这两种亚型缺血性卒中的不同动脉病理过程。我们进行了一项系统性综述，其中我们确定了具有缺血性卒中亚型特异性死亡、复发性卒中和/或心肌梗死（MI）随访数据的队列研究。我们计算了1个月、1-12个月和1-5年时的死亡和复发性卒中风险，以及MI和心源性死亡风险。我们使用研究特异性和汇总优势比比较了非腔隙性脑梗死和腔隙性脑梗死。我们还比较了腔隙性和非腔隙性脑梗死后复发性卒中亚型的模式。非腔隙性脑梗死后一个月内死亡和卒中复发的几率明显高于腔隙性脑梗死，但此后差异减小（1个月死亡率：OR 3.81，95% CI 2.77 - 5.23; 1-12个月死亡率：OR 2.32，95% CI 1.74 - 3.08; 1-5年死亡率：OR 1.77，95% CI 1.28 - 2.45; 1个月卒中复发OR 2.11，95% CI 1.20 - 3.69; 1-12个月卒中复发OR 1.24，95% CI 0.85 - 1.83; 1-5年卒中复发OR 1.61，95% CI 0.96 - 2.70）。如果指示事件是腔隙性的，则复发性卒中更可能是腔隙性的。很少有研究报道心肌梗死的风险，但我们发现非腔隙性梗死与腔隙性梗死的心源性死亡风险无显著差异。因此，尽管非腔隙性脑梗死患者的早期死亡率和卒中复发风险高于腔隙性脑梗死患者，但从长期来看，风险似乎没有差异，心脏结局的风险相似，尽管数据有限。有一些证据表明，复发性缺血性中风亚型的繁殖是正确的。这些结果为腔隙性脑梗死的特殊动脉病理提供了有限的支持。
Differences in prognosis of lacunar and non-lacunar infarction patients might support distinct arterial pathological processes underlying these two subtypes of ischaemic stroke. We did a systematic review in which we identified cohort studies with ischaemic stroke subtype-specific follow-up data on death, recurrent stroke and/or myocardial infarction (MI). We calculated risks of death and recurrent stroke at 1 month, 1-12 months and 1-5 years, as well as risks of MI and cardiac death. We compared non-lacunar with lacunar infarction, using study-specific and summary odds ratios. We also compared the pattern of recurrent stroke subtypes after lacunar and non-lacunar infarction. One month odds of death and of recurrent stroke were significantly greater following non-lacunar than lacunar infarction, but the difference decreased thereafter (one month mortality: OR 3.81, 95% CI 2.77 to 5.23; 1-12 month mortality: OR 2.32, 95% CI 1.74 to 3.08; 1-5 year mortality: OR 1.77, 95% CI 1.28 to 2.45; one month stroke recurrence OR 2.11, 95% CI 1.20 to 3.69; 1-12 month stroke recurrence OR 1.24, 95% CI 0.85 to 1.83; 1-5 year stroke recurrence OR 1.61, 95% CI 0.96 to 2.70). Recurrent strokes were more likely to be lacunar if the index event was lacunar. Few studies reported on the risk of MI, but we found no significant difference in risk of cardiac death in non-lacunar versus lacunar infarction. Thus, although early mortality and stroke recurrence risk are higher among non-lacunar than lacunar infarct patients, the risks appear not to differ in the longer term and the risks of cardiac outcomes are similar, although data are limited. There is some evidence that recurrent ischaemic stroke subtypes breed true. These results provide limited support for a distinct arterial pathology underlying lacunar infarction.
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影响因子：
8.3
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