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JAHA:心率对急性缺血性脑卒中患者结局的影响

2022-05-11 MedSci原创 MedSci原创

不像急性缺血性卒中(AIS)后对于血压的管理有具体的指导方针,然而对于AIS后心率的管理却没有指南予以明确或指导。以往关于心率对卒中后预后影响的文献十分有限。

不像急性缺血性卒中(AIS)后对于血压的管理有具体的指导方针,然而对于AIS后心率的管理却没有指南予以明确或指导。以往关于心率对卒中后预后影响的文献十分有限。

近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,研究人员旨在阐明(1)缺血性卒中急性期的心率是否能预测随后的主要临床事件,(2)哪个心率参数最适合预测临床事件,以及(3)预测主要结局的心率临界值是多少。

该研究对发病48小时内住院的831例急性缺血性卒中患者进行了回顾性分析。研究人员收集了发病后第4天至第7天的心率,评估心率参数,包括平均心率、时间加权平均心率、最大心率和最小心率。该研究的主要结局是卒中发作后1年内卒中复发、心肌梗死和死亡率的复合指标。

研究人员发现所有心率参数均与主要结局相关(P<0.001)。最大心率对主要结局具有最高的预测能力。主要结局的估计临界值为平均心率每分钟81次,最大心率每分钟100次。

心率高于这些临界值的患者发生主要结局的风险更高(最大心率调整风险比为1.80 [95%CI为1.57-2.06],平均心率调整风险比为1.65 [95%CI为1.45-1.89])。这种关联在一个单独的验证数据集中得到了重复(N=10000)。

由此可见,这些结果表明,急性期的心率是缺血性卒中患者主要临床事件的预测指标,最佳的心率控制可能是预防缺血性卒中后续心血管事件的目标。

原始出处:

Keon‐Joo Lee.et al.Effect of Heart Rate on 1‐Year Outcome for Patients With Acute Ischemic Stroke.JAHA.2022.https://www.ahajournals.org/doi/10.1161/JAHA.122.025861

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    2022-05-13 zhaohui6731
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