Neurology：新诊断房颤与晨起卒中和TIA独立相关

　　智利一项研究表明，新诊断房颤与晨起缺血性卒中和短暂性脑缺血发作（TIA）具有显著独立相关性，与无晨起事件患者相比，已发生晨起脑血管事件患者的新诊断房颤检测几率高3倍。论文4月17在线发表于《神经病学》（Neurology）。

　　研究者前瞻性评估2008至2011年间收治的所有急性缺血性卒中和TIA患者。对重要协变量进行校正之后，利用逐步多重Logistic回归分析评估新诊断房颤与晨起缺血性卒中或TIA的相关性。

　　结果显示，研究人群由356例患者组成，伴有急性缺血性卒中和TIA诊断者分别为274（77.0%）和82（23.0%）例。上述事件中有11.5%（41例）在晚间睡眠时发生。在272例无已知房颤患者中有27例被检出新诊断房颤（9.9%）。新诊断房颤与晨起缺血性卒中和TIA之间具有独立相关性（比值比3.6；P=0.019）。

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Newly diagnosed atrial fibrillation linked to wake-up stroke and TIA
Background
Based on the higher frequency of paroxysmal atrial fibrillation during night and early morning hours, we sought to analyze the association between newly diagnosed atrial fibrillation and wake-up ischemic cerebrovascular events.
Methods
We prospectively assessed every acute ischemic stroke and TIA patient admitted to our hospital between 2008 and 2011. We used a forward step-by-step multiple logistic regression analysis to assess the relationship between newly diagnosed atrial fibrillation and wake-up ischemic stroke or TIA, after adjusting for significant covariates.
Results
The study population comprised 356 patients, 274 (77.0%) with a diagnosis of acute ischemic stroke and 82 (23.0%) with TIA. A total of 41 (11.5%) of these events occurred during night sleep. A newly diagnosed atrial fibrillation was detected in 27 patients of 272 without known atrial fibrillation (9.9%). We found an independent association between newly diagnosed atrial fibrillation and wake-up ischemic stroke and TIA (odds ratio 3.6, 95% confidence interval 1.2–7.7, p = 0.019).
Conclusions
The odds of detecting a newly diagnosed atrial fibrillation were 3-fold higher among wake-up cerebrovascular events than among non–wake-up events. The significance of this independent association between newly diagnosed atrial fibrillation and wake-up ischemic stroke and TIA and the role of other comorbidities should be investigated in future studies.