Epidemiologic assessment of chronic atrial fibrillation and risk of stroke: The Framingham Study
Epidemiologic assessment of chronic atrial fibrillation and risk of stroke: The Framingham Study
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慢性心房颤动和中风风险的流行病学评估：弗雷明汉研究
DOI：
10.1212/01.wnl.0000407150.80523.a4
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发表时间：
2011
期刊：
影响因子：
9.9
通讯作者：
W. B. Kannel
中科院分区：
文献类型：
--
作者：
P. A. Wolf;T. Dawber;Emerson Thomas;W. B. Kannel
马萨诸塞州弗雷明汉对一般人群样本进行了 24 年的随访，对作为中风前兆的慢性心房颤动 (AF) 进行了评估。患有慢性房颤的人，无论是否患有风湿性心脏病 (RHD)，中风的风险都会大大增加，而中风可能是由于栓塞引起的。没有 RHD 的慢性 AF 与中风发病率增加五倍以上有关，而有 RHD 的 AF 则增加 17 倍。随着房颤持续时间的增加，中风的发生率也随之增加，但没有证据表明这是一个特别脆弱的时期。慢性特发性房颤是脑栓塞的重要前兆。对慢性房颤患者进行抗凝剂或抗心律失常药物的对照试验可能会证明，在这一高度易感人群中是否可以预防中风。
Chronic atrial fibrillation (AF) as a precursor of stroke was assessed over 24 years of follow-up of the general population sample at Framingham, Massachusetts. Persons with chronic established AF, with or without rheumatic heart disease (RHD), are at greatly increased risk of stroke, and the stroke is probably due to embolism. Chronic AF in the absence of RHD is associated with more than a fivefold increase in stroke incidence, while AF with RHD has a 17-fold increase. Stroke occurrence increased as duration of AF increased, with no evidence of a particularly vulnerable period. Chronic idiopathic AF is an important precursor of cerebral embolism. Controlled trials of anticoagulants or antiarrhythmic agents in persons with chronic AF may demonstrate if strokes can be prevented in this highly susceptible group.