Early ischaemic and haemorrhagic complications after atrial fibrillation-related ischaemic stroke: analysis of the IAC study.
Early ischaemic and haemorrhagic complications after atrial fibrillation-related ischaemic stroke: analysis of the IAC study.
复制标题
与房颤相关的缺血性中风后的早期缺血性和出血并发症：IAC研究的分析。
DOI：
10.1136/jnnp-2020-323041
复制
发表时间：
2020-07
期刊：
影响因子：
--
通讯作者：
Furie K
中科院分区：
文献类型：
--
作者：
Yaghi S;Henninger N;Scher E;Giles J;Liu A;Nagy M;Kaushal A;Azher I;Mac Grory B;Fakhri H;Espaillat KB;Asad SD;Pasupuleti H;Martin H;Tan J;Veerasamy M;Liberman AL;Esenwa C;Cheng N;Moncrieffe K;Moeini-Naghani I;Siddu M;Trivedi T;Leon Guerrero CR;Khan M;Nouh A;Mistry E;Keyrouz S;Furie K
房颤（AF）长期缺血性和出血性并发症的预测因素已经研究过，但关于AF相关缺血性卒中后早期缺血性和出血性并发症的预测因素的数据有限。我们试图确定这些预测因素。脑栓塞性卒中后开始抗凝治疗（IAC）研究是一项多中心回顾性研究，汇总了来自美国8家综合性卒中中心卒中登记研究的AF背景下缺血性卒中连续患者的数据。共同主要结局为90天内复发性缺血事件（卒中/TIA/全身动脉栓塞）和迟发性症状性颅内出血（d-sICH）。我们进行了单变量分析和考克斯回归分析，包括单变量分析的重要预测因素，以确定早期缺血性事件（卒中/TIA/全身性栓塞）和d-sICH的独立预测因素。在2084例患者中，1520例患者合格; 104例患者（6.8%）在索引事件后90天内发生复发性缺血事件，23例患者（1.5%）在索引事件后90天内发生d-sICH。在Cox回归模型中，与缺血性事件复发趋势相关的因素为既往卒中或TIA（HR 1.42，0.96 - 2.10）和同侧动脉狭窄伴50-99%狭窄（HR 1.54，0.98 - 2.43）。与sICH相关的因素为女性（HR 2.68，1.06- 6.83）、高脂血症史（HR 2.91，1.08 - 7.84）和早期出血性转化（HR 5.35，2.22 - 12.92）。在缺血性卒中和AF患者中，d-sICH的预测因子与复发性缺血性事件的预测因子不同，因此识别这些预测因子可能有助于告知早期卒中与d-sICH预防策略。
Predictors of long-term ischemic and hemorrhagic complications in atrial fibrillation (AF) have been studied, but there is limited data on predictors of early ischemic and hemorrhagic complications after AF associated ischemic stroke. We sought to determine these predictors. The Initiation of Anticoagulation after Cardioembolic stroke (IAC) study is a multicenter retrospective study across that pooled data from consecutive patients with ischemic stroke in the setting of AF from stroke registries across 8 comprehensive stroke centers in the United States. The co-primary outcomes were recurrent ischemic event (stroke/TIA/systemic arterial embolism) and delayed symptomatic intracranial hemorrhage (d-sICH) within 90 days. We performed univariate analyses and cox regression analyses including important predictors on univariate analyses to determine independent predictors of early ischemic events (stroke/TIA/systemic embolism) and d-sICH. Out of 2084 patients, 1520 patients qualified; 104 patients (6.8%) had recurrent ischemic events and 23 patients (1.5%) had d-sICH within 90 days from the index event. In cox-regression models, factors associated with a trend for recurrent ischemic events were prior stroke or TIA (HR 1.42, 0.96 – 2.10) and ipsilateral arterial stenosis with 50–99% narrowing (HR 1.54, 0.98 – 2.43). Those associated with sICH were female sex (HR 2.68, 1.06– 6.83), history of hyperlipidemia (HR 2.91, 1.08 – 7.84), and early hemorrhagic transformation (HR 5.35, 2.22 – 12.92). In patients with ischemic stroke and AF, predictors of d-sICH are different than those of recurrent ischemic events therefore recognizing these predictors may help inform early stroke versus d-sICH prevention strategies.
登录
查看更多内容
影响因子：
20.1
作者：
Kamel H;Healey JS
通讯作者：
Healey JS
影响因子：
9.9
作者：
Turan, Tanya N.;Nizam, Azhar;Chimowitz, Marc I.
通讯作者：
Chimowitz, Marc I.
影响因子：
8.3
作者：
Meier, Niklaus;Nedeltchev, Krassen;Arnold, Marcel
通讯作者：
Arnold, Marcel
影响因子：
8.3
作者：
HORNIG, CR;BAUER, T;DORNDORF, W
通讯作者：
DORNDORF, W
影响因子：
29
作者：
Yaghi S;Eisenberger A;Willey JZ
通讯作者：
Willey JZ