Self-Reported Atrial Fibrillation and Risk of Stroke in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study
Self-Reported Atrial Fibrillation and Risk of Stroke in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study
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DOI：
10.1161/strokeaha.111.621367
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发表时间：
2011-10-01
期刊：
影响因子：
8.3
通讯作者：
Howard, Virginia J.
中科院分区：
文献类型：
--
作者：
Soliman, Elsayed Z.;Howard, George;Howard, Virginia J.
背景和目的-我们比较了自我报告的心房颤动（AF）和ECG检测到的AF与卒中风险中卒中事件的相关性，卒中的地理和种族差异的原因（REGARDS）study. Methods-在这项分析中，纳入了27109名年龄在45岁或45岁以上且既往无卒中的参与者。在平均4.4年的随访期间确定并裁定了卒中病例。使用考克斯比例风险分析计算自我报告的AF、ECG检测到的AF和通过任一方法检测到的AF与突发卒中的风险比（HR）。我们还研究了当房颤成分由不同方法定义时，房颤卒中风险评分（FSRS）的预测能力。结果-在调整FSRS成分后，自我报告的房颤、ECG检测的房颤和任何一种方法的房颤均可预测卒中事件（HR，1.41; 95% CI，1.05-1.88; HR，1.90; 95% CI，1.10-3.27; HR，1.53; 95% CI，1.16-2.01）。当自我报告、ECG或任一方法分别被视为FSRS中的AF确定方法时，FSRS每增加1%的HR在AF确定方法中相同（HR，1.04; 95%CI，1.03-1.04; HR，1.04; 95%CI，1.04-1.05; HR，1.04; 95%CI，1.03-1.04; respectively）.结论--自我报告的AF是卒中的强预测因子，在卒中风险预测模型中可互换使用或与ECG检测的AF结合使用。（中风。2011;42：2950-2953）。
Background and Purpose-We compared the associations of self-reported atrial fibrillation (AF) and ECG-detected AF with incident stroke in the Risk of Stroke in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study.Methods-In this analysis, 27 109 participants aged 45 years or older without previous stroke were included. Stroke cases were identified and adjudicated during an average of 4.4 years of follow-up. Cox proportional hazards analysis was used to calculate hazard ratios (HR) of self-reported AF, ECG-detected AF, and AF detected by either method with incident stroke. We also examined the predictive ability of the Framingham Stroke Risk Score (FSRS) when the component AF was defined by different methods.Results-After adjustment for components of the FSRS, self-reported AF, ECG-detected AF, and AF by either method were predictive of incident stroke (HR, 1.41; 95% CI, 1.05-1.88; HR, 1.90; 95% CI, 1.10-3.27; HR, 1.53; 95% CI, 1.16-2.01, respectively). When self-report, ECG, or either method, separately, were considered as the method of AF ascertainment in the FSRS, the HR per 1% increase in the FSRS were identical across AF ascertainment methods (HR, 1.04; 95% CI, 1.03-1.04; HR, 1.04; 95% CI, 1.04-1.05; HR, 1.04; 95% CI, 1.03-1.04; respectively).Conclusions-Self-reported AF is a strong predictor of stroke that can be used interchangeably or in combination with ECG-detected AF in stroke risk prediction models. (Stroke. 2011;42:2950-2953.)