Age-related macular degeneration and long-term risk of stroke subtypes.
Age-related macular degeneration and long-term risk of stroke subtypes.
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DOI：
10.1161/strokeaha.112.654632
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发表时间：
2012-06
期刊：
影响因子：
8.3
通讯作者：
Wong TY
中科院分区：
文献类型：
--
作者：
Ikram MK;Mitchell P;Klein R;Sharrett AR;Couper DJ;Wong TY
我们研究了年龄相关性黄斑变性（AMD）与中风事件的关系，包括脑梗塞和脑出血（ICH）的中风亚型。我们纳入了社区动脉粥样硬化风险研究 (ARIC) 中的 12,216 名参与者，他们在第三次检查访问（1993-1995 年）时拍摄了视网膜照片，这是一项针对中年人的基于人群的队列研究。根据标准化协议对图像进行 AMD 迹象评估。随着时间的推移，通过病例记录审查来识别和验证中风及其亚型的事件。 591 名参与者被诊断出 AMD，其中 576 名患有早期 AMD，15 名患有晚期 AMD。平均随访 13.0 年（标准差：3.3）后，619 人发生中风，其中 548 人脑梗死，57 人脑出血。患有任何AMD的参与者中风的风险增加（多变量调整风险比[HR]：1.51；95%置信区间[CI]：1.11-2.06），与ICH（HR：2.64；95% CI：1.18-5.87）的相关性比脑梗死（HR：1.42；95% CI：1.01-1.99）更强。 AMD 患者发生脑梗塞和脑出血的风险增加。这些数据进一步深入了解 AMD 和中风亚型之间常见的病理生理过程。
We examined the relationship of age-related macular degeneration (AMD) with incident stroke, including stroke subtypes of cerebral infarction and intracerebral haemorrhage (ICH). We included 12,216 participants with retinal photographs taken at the third examination visit (1993–1995) from the Atherosclerosis Risk in Communities Study (ARIC), a population-based cohort study in middle-aged persons. Images were evaluated for AMD signs according to a standardized protocol. Incident events of stroke and its subtypes were identified and validated via case record review over time. AMD was diagnosed in 591 participants, of whom 576 had early and 15 late AMD. After a mean follow-up of 13.0 years (standard deviation: 3.3), 619 persons developed an incident stroke, including 548 cerebral infarction and 57 ICH. Participants with any AMD were at an increased risk of stroke (multi-variable adjusted hazard ratio [HR]: 1.51; 95% confidence interval [CI]: 1.11–2.06), with a stronger association for ICH (HR: 2.64; 95% CI: 1.18–5.87) than cerebral infarction (HR: 1.42; 95% CI: 1.01–1.99). Persons with AMD are at an increased risk of both cerebral infarction and ICH. These data provide further insights into common pathophysiological processes between AMD and stroke subtypes.