Cerebral small vessel disease was associated with the prognosis in ischemic stroke with atrial fibrillation

IF 4.8 1区医学 Q1 NEUROSCIENCES

CNS Neuroscience & Therapeutics Pub Date : 2024-10-21 DOI:10.1111/cns.70052

Yicong Wang, Hang Li, Yuesong Pan, Mengxing Wang, Xiaoling Liao, Yingying Yang, Weiqi Chen, Xia Meng, Yongjun Wang, Yilong Wang

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Abstract

Background

The purpose of this study was to explore the relationship between atrial fibrillation (AF), cerebral small vessel disease (CSVD), and ischemic stroke.

Methods

Data were extracted from China's Third National Stroke Registry (CNSR-III), which registered 15,166 patients in China. A total of 12,180 ischemic stroke patients were included excluding those diagnosed with TIA or without MRI. Logistic regression was to explore the relationship between AF, CSVD, and poor functional outcomes at 12-month follow-up. Cox regression is to explore AF, CSVD, and stroke recurrence as well as all-cause mortality at 12-month follow-up.

Results

The average age was 62.40 ± 11.22 years old, and 8362 (68.65%) were men at baseline. Patients with AF had an increased risk of stroke recurrence and all-cause mortality at 12-month follow-up. Those with AF and CSVD imaging such as lacunes, white matter hyperintensity (WMH), and the presence of cerebral microbleeds (CMBs) had an increased risk of poor prognosis. And those with both AF and CSVD burden had an increased risk of worse prognosis at 12-month follow-up.

Conclusion

Among Chinese patients with acute ischemic stroke, those with AF were associated with a higher risk of 12-month mortality and stroke recurrence. When AF was combined with some CSVD imaging features such as lacunes, WMH, presence of CMBs or burdens, the 12-month poor prognosis worsened.

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脑小血管疾病与心房颤动缺血性卒中的预后有关。

背景：本研究旨在探讨心房颤动（AF）、脑小血管疾病（CSVD）和缺血性中风之间的关系：本研究旨在探讨心房颤动（AF）、脑小血管病（CSVD）与缺血性卒中之间的关系：数据来源于中国第三次全国脑卒中登记（CNSR-III）。共纳入 12180 例缺血性脑卒中患者，其中不包括诊断为 TIA 或未进行 MRI 检查的患者。Logistic 回归是为了探讨房颤、CSVD 和 12 个月随访时功能预后不良之间的关系。Cox 回归是为了探究房颤、CSVD 和中风复发以及随访 12 个月的全因死亡率：平均年龄为（62.40 ± 11.22）岁，基线时有 8362 人（68.65%）为男性。心房颤动患者中风复发风险和随访 12 个月的全因死亡率均有所上升。心房颤动和 CSVD 影像（如裂隙、白质高密度（WMH）和脑微出血（CMB））患者预后不良的风险增加。同时伴有房颤和CSVD负担的患者在12个月的随访中预后不良的风险增加：结论：在中国急性缺血性卒中患者中，房颤患者的 12 个月死亡率和卒中复发风险较高。结论：在中国急性缺血性卒中患者中，心房颤动患者12个月内死亡和卒中复发的风险较高，当心房颤动合并一些CSVD影像学特征（如裂隙、WMH、CMB或负担）时，12个月内不良预后会加重。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

CNS Neuroscience & Therapeutics 医学-神经科学

CiteScore

7.30

自引率

12.70%

发文量

240

审稿时长

2 months

期刊介绍： CNS Neuroscience & Therapeutics provides a medium for rapid publication of original clinical, experimental, and translational research papers, timely reviews and reports of novel findings of therapeutic relevance to the central nervous system, as well as papers related to clinical pharmacology, drug development and novel methodologies for drug evaluation. The journal focuses on neurological and psychiatric diseases such as stroke, Parkinson’s disease, Alzheimer’s disease, depression, schizophrenia, epilepsy, and drug abuse.