Incidence of stroke among chronic hemodialysis patients with nonrheumatic atrial fibrillation
Incidence of stroke among chronic hemodialysis patients with nonrheumatic atrial fibrillation
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DOI：
10.1159/000046216
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发表时间：
2001-01-01
影响因子：
4.2
通讯作者：
Balcke, P
中科院分区：
文献类型：
--
作者：
Wiesholzer, M;Harm, F;Balcke, P
一般来说，非风湿性心房颤动与中风的高风险有关。然而，在慢性血液透析治疗的背景下，其对中风的影响在文献中没有得到充分的阐述。我们评估了430名慢性血液透析患者的中风发生率，以及心房颤动和其他各种潜在危险因素对中风的影响，这项回顾研究覆盖了111.16个病人年。卒中总发病率为3.78/100病人年。在除常规透析抗凝外未进行任何抗血栓治疗的慢性房颤患者中，卒中发生率为1/10万人年，与无心律失常患者的发生率(2.8/100人年)相比，差异无统计学意义(P=0.220)。相反，糖尿病肾病(6.46，p=0.0036)、年龄和65岁(5.9，p=0.0001)、中到重度高血压(6.8，p=0.0017)、透析间隔体重增加2公斤(6.47，p=0.0433)和接受水杨酸盐或华法林抗血栓治疗(8.33，p=0.0002)的患者每百人年卒中的总发生率显著高于没有这些危险因素的相应组。我们的数据表明，与其他危险因素相比，非风湿性房颤本身与接受维持性血液透析治疗的患者卒中风险增加无关。版权所有(C)2001 S.Karger AG，巴塞尔。
In general, nonrheumatic atrial fibrillation is associated with a high risk of stroke. However, its impact on stroke in the setting of chronic hemodialysis treatment is insufficiently addressed in the literature. We assessed the incidence of stroke among 430 chronic hemodialysis patients and the impact of atrial fibrillation and various other potential risk factors on stroke in a retrospective study covering 1,111.16 patient-years. The overall incidence of stroke was 3.78/100 patient-years. Among patients with chronic atrial fibrillation without any antithrombotic therapy besides regular dialysis anticoagulation, the stroke incidence was 1.0/100 patient-years and did not differ statistically significantly from the rate among patients without this arrhythmia, in whom the incidence was 2.8/100 patient-years (p = 0.220). Conversely, the overall rate of stroke incidence per 100 patient-years was statistically significantly higher in patients with diabetic nephropathy (6.46, p = 0.0036), age >65 years (5.90, p = 0.0001), moderate to severe hypertension (6.8, p = 0.0017), weight gain of >2 kg between dialyses as a marker of poor patient compliance (6.47, p = 0.0433), and antithrombotic therapy with salicylates or warfarin (8.33, p = 0.0002), as compared with corresponding groups without these risk factors. Our data suggest that in contrast to other risk factors nonrheumatic atrial fibrillation in itself is not associated with an increased risk of stroke in patients on maintenance hemodialysis treatment. Copyright (C) 2001 S. Karger AG, Basel.