大血管或小血管疾病导致中风后心房颤动的检测:系统回顾和荟萃分析。

IF 6.3 2区 医学 Q1 CLINICAL NEUROLOGY
Matilda Florentin, Dimitrios Sagris, Panagiotis Tasoudis, Eleni Korompoki, Roland Veltkamp, Lucio D'Anna, Rolf Wachter, Haralampos Milionis, George Ntaios
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引用次数: 0

摘要

背景:新的证据表明,与房颤无关的缺血性卒中已有明确病因的患者中经常出现房颤检测。目的:我们对截至 2024 年 3 月 2 日的 PubMed 和 Scopus 数据库进行了全面检索,以确定评估大血管或小血管疾病卒中患者房颤检出率的随机对照试验、非随机前瞻性研究和回顾性研究。我们关注的主要结果是房颤的检出率。我们利用逆方差加权法得出了被诊断为卒中后房颤患者的汇总患病率(效应大小-ES)和 95% 置信区间(CI):在对14项符合条件的研究(包括4334名患者)进行的分析中,在2082名因小血管或大血管疾病导致卒中的患者中,有154人被确诊为房颤,汇总患病率为6.27%(ES;95%置信区间[CI]:3.18-10.17,I2=87.83%)。在大血管疾病脑卒中患者中,1,042 位患者中有 79 位确诊为房颤,汇总患病率为 5.07%(ES;95% 置信区间 [CI]:1.30-10.33,I2=77.05%)。同样,在小血管疾病脑卒中患者中,1,040 位患者中有 75 位检测到房颤,总患病率为 5.03% (ES;95% CI:1.96-9.06,I2=78.05%):结论:心房颤动常出现在患有大血管或小血管疾病的缺血性卒中患者中。结论:心房颤动常在患有大血管或小血管疾病的缺血性卒中患者中发现,随着心律监测时间的延长,发现率也会增加。口服抗凝药对这些房颤发作的安全性和益处尚不确定。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Detection of atrial fibrillation after stroke due to large or small vessel disease: Systematic review and meta-analysis.

Background: Emerging evidence indicates a frequent occurrence of atrial fibrillation (AF) detection among patients with established causes of ischemic stroke unrelated to AF. This systematic review and meta-analysis aimed to evaluate AF detection rates in stroke patients with large or small vessel disease, considering the AF detection modality and duration of cardiac rhythm monitoring.

Aims: We conducted a comprehensive search of PubMed and Scopus databases up to 2 March 2024, to identify randomized controlled trials, non-randomized prospective studies, and retrospective studies assessing the frequency of AF detection in stroke patients with large or small vessel disease. The primary outcome of interest was the rate of AF detection. We utilized inverse-variance weights to produce the pooled prevalence (effect size (ES)) and 95% confidence interval (CI) of patients diagnosed with post-stroke AF.

Summary of review: In the analysis of 14 eligible studies encompassing 4334 patients, AF was identified in 154 out of 2082 patients with strokes attributed to small or large vessel disease, yielding a pooled prevalence of 6.27% (ES; 95% confidence interval (CI): 3.18-10.17, I2 = 87.83%). Among patients with large vessel disease strokes, AF was diagnosed in 79 out of 1042 patients, accounting for a pooled prevalence of 5.07% (ES; 95% CI: 1.30-10.33, I2 = 77.05%). Similarly, among those with small vessel disease strokes, AF was detected in 75 out of 1040 patients, with a pooled prevalence of 5.03% (ES; 95% CI: 1.96-9.06, I2 = 78.05%).

Conclusions: AF is often found in ischemic stroke patients with large or small vessel disease. Detection rates increase with longer cardiac rhythm monitoring. The safety and benefits of oral anticoagulation for these AF episodes are uncertain.

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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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