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Stroke:加拿大研究:首次卒中后患者30天内新发心脏病风险升高20多倍

2020-01-11 xujing 中国循环杂志

卒中杂志发表的一项加拿大研究发现,首次卒中患者30天内新发心脏病风险升高20多倍。

卒中杂志发表的一项加拿大研究发现,首次卒中患者30天内新发心脏病风险升高20多倍。
 
研究纳入93627名≥66岁老年受试者,均没有心脏病。21 931名首次缺血性卒中的受试者与71 696名无卒中的受试者进行倾向匹配。
 
研究发现,首次缺血性卒中与不良心血管事件的风险增加相关,且呈时间依赖性。
 
首次卒中后30天之后发生不良心血管事件(包括:急性冠脉综合征、心肌梗死、冠心病、冠状动脉重建术、心力衰竭或心血管死亡)的风险最高,女性和男性的风险分别升高25倍和23倍。
 
即使卒中1年后,其发生不良心血管事件的风险仍然是没有卒中的同龄人的两倍。

 一般我们会想到,这种联系可能与心脏病和卒中之间的共同危险因素如高血压糖尿病或吸烟等有关,
 
但是,研究者指出,在没有心脏病的人身上看到这种联系,这提示其他机制也参与其中 。
 
研究者推断,心脏和大脑有着深层的神经联系,卒中相关的脑损伤会导致自主神经功能障碍和炎症,进而导致心脏并发症,今后需要开展深入研究探索卒中引发心脏问题的机制,这最终为如何预防这些问题带来新的思路。
 
同时,还强调,临床医生应重点关注卒中患者出现的冠状动脉疾病症状或隐匿的心脏病以早期干预。
 
原始出处:Sposato LA, Lam M, Allen B, et al. First-Ever Ischemic Stroke and Incident Major Adverse Cardiovascular Events in 93 627 Older Women and Men. Stroke, 2020 Jan 9

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    2020-01-12 smlt2008
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  6. [GetPortalCommentsPageByObjectIdResponse(id=1977824, encodeId=9c8019e7824b5, content=<a href='/topic/show?id=93a211600a' target=_blank style='color:#2F92EE;'>#30天#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1160, encryptionId=93a211600a, topicName=30天)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c39f145, createdName=smlt2008, createdTime=Sun Jan 12 04:20:00 CST 2020, time=2020-01-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1671391, encodeId=9d4616e139150, content=<a href='/topic/show?id=9f4e360191a' target=_blank style='color:#2F92EE;'>#卒中后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36019, encryptionId=9f4e360191a, topicName=卒中后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ff7426824786, createdName=waiwai3039, createdTime=Sat Oct 31 02:20:00 CST 2020, time=2020-10-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1312633, encodeId=5c1d13126339f, content=<a href='/topic/show?id=1aa333006b4' target=_blank style='color:#2F92EE;'>#加拿大#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33006, encryptionId=1aa333006b4, topicName=加拿大)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=279b407, createdName=shanyongle, createdTime=Mon Jan 13 14:20:00 CST 2020, time=2020-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1559739, encodeId=a0961559e3999, content=<a href='/topic/show?id=b8435162302' target=_blank style='color:#2F92EE;'>#心脏病风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51623, encryptionId=b8435162302, topicName=心脏病风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=94f015012402, createdName=mgqwxj, createdTime=Mon Jan 13 14:20:00 CST 2020, time=2020-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1565748, encodeId=32cc1565e48bd, content=<a href='/topic/show?id=b8435162302' target=_blank style='color:#2F92EE;'>#心脏病风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51623, encryptionId=b8435162302, topicName=心脏病风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=94f015012402, createdName=mgqwxj, createdTime=Mon Jan 13 14:20:00 CST 2020, time=2020-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378061, encodeId=e6d63e80618f, content=很好的学习机会, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/04/12/cd30eefc465f70dc4dad89bd57479781.jpg, createdBy=02be2318568, createdName=一天没事干, createdTime=Sun Jan 12 07:52:52 CST 2020, time=2020-01-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026532, encodeId=acf61026532f1, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Sun Jan 12 02:20:00 CST 2020, time=2020-01-12, status=1, ipAttribution=)]
    2020-01-12 一天没事干

    很好的学习机会

    0

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    2020-01-12 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

    0

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由此可见,初步诊断为房颤后,利伐沙班和华法林治疗的患者卒中风险显著降低,尤其是严重卒中和卒中后全因死亡率。这项观察性研究的结果可能有助于为非瓣膜性房颤患者卒中预防选择合适的抗凝药物。

Neurology:睡眠时间、午睡、睡眠质量与卒中

由此可见,睡眠时间长、午睡时间长和睡眠质量差是与卒中发生风险较高相关的独立因素。持续较长的睡眠时间或从平均睡眠时间切换为长时间睡眠会增加卒中的风险。

Neurology:血浆三甲胺N-氧化物水平升高与卒中损伤增加之间的关系

由此可见,缺血性卒中患者血浆TMAO水平高于健康对照者。入院时血浆TMAO水平升高是急性缺血卒中患者严重程度和梗死体积的独立预测因子。

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