中风-心脏综合征：脑出血后心脏并发症的发病率和临床结果。

IF 5.8 3区医学 Q1 CLINICAL NEUROLOGY

European Stroke Journal Pub Date : 2024-07-30 DOI:10.1177/23969873241264115

Katie L Hoad, Helen Jones, Gemma Miller, Azmil H Abdul-Rahim, Gregory Yh Lip, Benjamin Jr Buckley

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引用次数: 0

摘要

导言：缺血性卒中后新诊断出的心血管并发症（称为卒中-心脏综合征）很常见，并与较差的预后相关。人们对与脑内出血（ICH）相关的卒中-心脏综合征知之甚少。本研究旨在利用全球联合数据库，调查发生 ICH 后新诊断的心血管并发症（MACE；急性心肌梗死、缺血性中风、全因死亡率和复发性 ICH）的发病率和 5 年主要不良心血管事件（MACE）：采用匿名电子病历进行了一项回顾性队列研究。研究纳入了年龄 ⩾ 18 岁的非创伤性 ICH 患者，并进行了 5 年随访。首次 ICH 后 4 周内新诊断出心血管并发症的患者与未新发心血管并发症的患者进行 1:1 的倾向评分匹配。每种心血管并发症都作为中风-心脏综合征复合群组进行调查，并分别调查相关的 MACE。采用 Cox 危险回归模型确定 MACE 的 5 年发病率：在倾向评分匹配前，171,489 名非创伤性 ICH 患者中，15%（n = 26,449）在 4 周内发生过⩾1 次新诊断的心血管并发症。配对后，与配对对照组相比，ICH 和心血管并发症患者的 5 年 MACE 风险明显更高（HR 1.35 [95% CI 1.32-1.38]）。5年随访期间再次住院的风险并不明显[HR 0.90 [0.73-1.13]]。新诊断出心血管并发症的患者发生MACE的风险明显更高：讨论与结论：ICH术后新确诊的心血管并发症（即卒中-心脏综合征）很常见，且与5年预后明显恶化有关。

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Stroke-heart syndrome: Incidence and clinical outcomes of cardiac complications following intracerebral haemorrhage.

Introduction: Newly diagnosed cardiovascular complications following an ischaemic stroke, termed stroke-heart syndrome, are common and associated with worse outcomes. Little is known regarding stroke-heart syndrome in relation to intracerebral haemorrhage (ICH). This study aimed to investigate the incidence and 5-year major adverse cardiovascular events (MACE; acute myocardial infarction, ischaemic stroke, all-cause mortality and recurrent ICH) of newly diagnosed cardiovascular complications following incident ICH, using a global federated database.

Patients and methods: A retrospective cohort study was conducted using anonymised electronic medical records. Patients aged ⩾ 18 years with non-traumatic ICH and 5-year follow-up were included. Patients with newly diagnosed cardiovascular complications within 4-weeks following the initial ICH were 1:1 propensity score-matched with patients without new-onset cardiovascular complications. Each cardiovascular complications were investigated as a composite stroke-heart syndrome cohort and separately for associated MACE. Cox hazard regression models were used to determine 5-year incidence of MACE.

Results: Before propensity score matching, 171,489 patients with non-traumatic ICH, 15% (n = 26,449) experienced ⩾1 newly diagnosed cardiovascular complication within 4 weeks. After matching, patients with ICH and cardiovascular complications were associated with a significantly higher risk of 5-year MACE (HR 1.35 [95% CI 1.32-1.38]), and in each composite compared to matched controls. There was no significant risk of rehospitalisation over 5-year follow-up [HR 0.90 [0.73-1.13]). The risk of MACE was significantly higher in patients with newly diagnosed cardiovascular complications.

Discussion and conclusions: Newly diagnosed cardiovascular complications following ICH (i.e. stroke-heart syndrome) were common and associated with a significantly worsened 5-year prognosis.

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来源期刊

European Stroke Journal Multiple-

CiteScore

7.50

自引率

6.60%

发文量

102

期刊介绍： Launched in 2016 the European Stroke Journal (ESJ) is the official journal of the European Stroke Organisation (ESO), a professional non-profit organization with over 1,400 individual members, and affiliations to numerous related national and international societies. ESJ covers clinical stroke research from all fields, including clinical trials, epidemiology, primary and secondary prevention, diagnosis, acute and post-acute management, guidelines, translation of experimental findings into clinical practice, rehabilitation, organisation of stroke care, and societal impact. It is open to authors from all relevant medical and health professions. Article types include review articles, original research, protocols, guidelines, editorials and letters to the Editor. Through ESJ, authors and researchers have gained a new platform for the rapid and professional publication of peer reviewed scientific material of the highest standards; publication in ESJ is highly competitive. The journal and its editorial team has developed excellent cooperation with sister organisations such as the World Stroke Organisation and the International Journal of Stroke, and the American Heart Organization/American Stroke Association and the journal Stroke. ESJ is fully peer-reviewed and is a member of the Committee on Publication Ethics (COPE). Issues are published 4 times a year (March, June, September and December) and articles are published OnlineFirst prior to issue publication.