【medical-news】Stroke:无症状性颈动脉狭窄不增加有临床表现动脉疾病患者的缺血性卒中风险

无症状性颈动脉狭窄与有临床表现动脉疾病患者的缺血性卒中风险(根据卒中亚型)
Background and Purpose—Because best medicaltreatment is improving, the risk of stroke in asymptomatic carotid arterystenosis (ACAS) may decline. We evaluated the risk of ischemic stroke andstratified it according to stroke subtype in patients with ACAS duringlong-term follow-up.
背景和目的:因为药物治疗对改善无症状性颈动脉狭窄(ACAS)患者卒中风险的效果可能下降。我们在长期随访中评估ACAS缺血性卒中的风险,并根据卒中亚型进行分层。
Methods—In total, 4319 consecutive patientsin the Second Manifestations of Arterial disease study with clinically manifestarterial disease or specific risk factors, but without a history ofcerebrovascular disease, were included. Degree of stenosis was evaluated withduplex ultrasound scanning. Strokes during follow-up were classified accordingto subtype. Cox-proportional hazard-regression models were used to evaluate therelationship between ACAS and future stroke.
方法:动脉疾病第二表现研究中共连续纳入4319位患者,他们伴有动脉疾病临床表现或特异危险因素,但没有脑血管疾病。狭窄程度使用多普勒超声扫描进行评估。随访的卒中根据亚型进行分类。使用Cox构成比风险回归模型评估ACAS和以后卒中的关系。
Results—We identified 293 (6.8%) patientswith ACAS 50% to 99%, of whom 193 had 70% to 99% stenosis. In these subgroups,mean follow-up was 6.2 and 6.0 years, respectively. In total, 94 ischemicstrokes occurred, of which 8 in ACAS 50% to 99% patients. The any territoryannual ischemic stroke risk was 0.4% in 50% to 99% ACAS and 0.5% per year for70% to 99% ACAS patients. The risk of ischemic stroke was not significantlyincreased in patients with ACAS 70% to 99% (hazard ratio, 1.5; 95% confidenceinterval, 0.7–3.5). Patients with ACAS 50% to 99% and ACAS 70% to 99% tended tohave nonsignificantly more large vessel disease strokes (hazard ratio, 1.5; 95%confidence interval, 0.5–4.2 and hazard ratio, 1.7; 95% confidence interval,0.5–5.6).
结果:我们确认了293位ACAS程度为50-99%的患者,占6.8%。其中有193位患者狭窄程度在70-99%。在这些亚组中,平均随访时间分别为6.2和6.0年。共发生94例缺血性卒中,其中8为ACAS狭窄程度在50-90%之间。狭窄程度50-99%患者的年缺血性卒中风险为0.4%;狭窄程度70-99%患者的年缺血性卒中风险为0.5%。ACAS狭窄程度在70-99%没有显著增加缺血性卒中的风险(风险比:1.5; 95%可信区间:0.7–3.5)。ACAS狭窄程度50%-99%与ACAS 狭窄程度70%-99%没有显著增加大血管病卒中风险(风险比:1.5; 95%可信区间:0.5–4.2,而风险比:1.7; 95%可信区间:0.5–5.6)。
Conclusions—Patients with clinicallymanifest arterial disease or type 2 diabetes mellitus have a low risk ofdeveloping ischemic stroke, irrespective of its subtype and independent of thedegree of ACAS stenosis.
结论:伴动脉疾病临床表现或2型糖尿病的患者出现缺血性卒中的风险低,无论它的亚型和ACAS狭窄程度。
Stroke:无症状性颈动脉狭窄不增加有临床表现动脉疾病患者的缺血性卒中风险
因为药物治疗改善无症状性颈动脉狭窄(ACAS)患者卒中风险的效果可能下降。为了评估ACAS缺血性卒中的风险,并根据卒中亚型进行分层,荷兰乌特勒支大学医学中心血管外科的Anne G. den Hartog博士等人进行了一项研究,研究结果在线发表在2013年2月12日的Stroke杂志上。研究结果发现:伴动脉疾病临床表现或2型糖尿病的患者出现缺血性卒中的风险低,无论它的亚型和ACAS狭窄程度。
该研究为动脉疾病第二表现研究。研究中共连续纳入4319位患者,他们伴有动脉疾病临床表现或特异危险因素,但没有脑血管疾病。狭窄程度使用多普勒超声扫描进行评估。随访的卒中根据亚型进行分类。使用Cox构成比风险回归模型评估ACAS和以后卒中的关系。
研究结果显示:共确认了293位ACAS程度为50-99%的患者,占6.8%。其中有193位患者狭窄程度在70-99%。在这些亚组中,平均随访时间分别为6.2和6.0年。共发生94例缺血性卒中,其中8为ACAS狭窄程度在50-90%之间。狭窄程度50-99%患者的年缺血性卒中风险为0.4%;狭窄程度70-99%患者的年缺血性卒中风险为0.5%。ACAS狭窄程度在70-99%没有显著增加缺血性卒中的风险(风险比:1.5; 95%可信区间:0.7–3.5)。ACAS狭窄程度50%-99%与ACAS 狭窄程度70%-99%没有显著增加大血管病卒中风险(风险比:1.5; 95%可信区间:0.5–4.2,而风险比:1.7; 95%可信区间:0.5–5.6)。
该研究发现:伴动脉疾病临床表现或2型糖尿病的患者出现缺血性卒中的风险低,无论它的亚型和ACAS狭窄程度。
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最后编辑于 2022-10-09 · 浏览 929