卵圆孔闭合术后复发性缺血性中风/短暂性脑缺血发作:一项队列研究。

IF 6.3 2区 医学 Q1 CLINICAL NEUROLOGY
Henrik Sørensen, Erik L Grove, Johanne Andersen Hojbjerg, Asger Andersen, Jens Erik Nielsen-Kudsk, Claus Z Simonsen
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引用次数: 0

摘要

背景:卵圆孔未闭(PFO)与缺血性中风和短暂性脑缺血发作(TIA)有关。指南建议对特定患者进行 PFO 关闭以预防中风,但与背景人群相比,复发中风的风险仍然很高。我们的目的是评估 PFO 关闭术后患者复发中风/TIA 的原因和介入治疗后的并发症:纳入了丹麦中部地区在2018年11月5日至2023年5月12日期间在奥胡斯大学医院接受PFO闭合术的缺血性中风、TIA、昏厥或视网膜栓塞患者。从电子病历中收集了有关患者人口统计学、风险因素、手术细节、介入后并发症和复发中风/TIA的数据:310名患者(中位年龄:49岁)接受了PFO闭合术。中位随访 2.6 年(四分位间范围:1.5-3.6,患者总年数为 814 年),发现 8 例患者(2.6%)复发中风/TIA,即每 100 患者年复发中风 0.98 例。高血压患者中复发性卒中/TIA 的发生率更高(50.0% vs 16.9%,p = 0.039)。62.5%的患者的复发性中风/TIA 与血栓性疾病或导致高凝状态的血液病有关。术后 45 天内,9.4% 的患者出现新发心房颤动。这些患者随后均未发生缺血性事件。其他不良后果并不常见:结论:PFO闭合术后缺血性中风/TIA复发率与之前的试验结果相当。已有的血管风险因素(高血压)和高凝状态与缺血性中风/TIA复发有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Recurrent ischemic stroke/transient ischemic attack after patent foramen ovale closure: A cohort study.

Background: Patent foramen ovale (PFO) has been associated with ischemic stroke and transient ischemic attack (TIA). Guidelines recommend PFO closure for stroke prevention in selected patients, but the risk of recurrent stroke remains high compared to the background population. We aimed to evaluate the causes of recurrent stroke/TIA and post-interventional complications in patients after PFO closure.

Methods: Patients from the Central Denmark Region who underwent PFO closure at Aarhus University Hospital between November 5, 2018, and May 12, 2023, following an ischemic stroke, TIA, amaurosis fugax, or retinal emboli were included. Data on patient demographics, risk factors, procedural details, post-interventional complications, and recurrent stroke/TIA were collected from electronic medical records.

Results: PFO closure was performed in 310 patients (median age: 49 years). During a median follow-up of 2.6 years (interquartile range: 1.5-3.6, 814 total patient-years), recurrent stroke/TIA was observed in 8 patients (2.6%), or 0.98 recurrent strokes per 100 patient-years. Recurrent stroke/TIA was more frequent in patients with hypertension (50.0% vs. 16.9%, p = 0.039). Recurrent stroke/TIA was related to thrombophilia or hematologic conditions entailing hypercoagulability in 62.5% of patients. New-onset atrial fibrillation was observed in 9.4% of patients within 45 days after the procedure. None of these patients subsequently developed an ischemic event. Other adverse outcomes were uncommon.

Conclusion: Rates of recurrent ischemic stroke/TIA after PFO closure were comparable to findings in previous trials. Pre-existing vascular risk factors (hypertension), and a hypercoagulable state were associated with recurrent ischemic stroke/TIA.

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来源期刊
International Journal of Stroke
International Journal of Stroke 医学-外周血管病
CiteScore
13.90
自引率
6.00%
发文量
132
审稿时长
6-12 weeks
期刊介绍: The International Journal of Stroke is a welcome addition to the international stroke journal landscape in that it concentrates on the clinical aspects of stroke with basic science contributions in areas of clinical interest. Reviews of current topics are broadly based to encompass not only recent advances of global interest but also those which may be more important in certain regions and the journal regularly features items of news interest from all parts of the world. To facilitate the international nature of the journal, our Associate Editors from Europe, Asia, North America and South America coordinate segments of the journal.
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