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欧洲缺血性卒中后主要危险因素的控制:来自EUROASPIRE III调查中卒中特异性模块的数据。

Control of main risk factors after ischaemic stroke across Europe: data from the stroke-specific module of the EUROASPIRE III survey.

作者信息

Heuschmann Peter U, Kircher Julia, Nowe Tim, Dittrich Ralf, Reiner Zeljko, Cifkova Renata, Malojcic Branko, Mayer Otto, Bruthans Jan, Wloch-Kopec Dorota, Prugger Christof, Heidrich Jan, Keil Ulrich

机构信息

Institute of Clinical Epidemiology and Biometry and Comprehensive Heart Failure Center, University of Würzburg, Germany Clinical Trial Center Würzburg, University Hospital Würzburg, Germany.

Institute of Clinical Epidemiology and Biometry and Comprehensive Heart Failure Center, University of Würzburg, Germany.

出版信息

Eur J Prev Cardiol. 2015 Oct;22(10):1354-62. doi: 10.1177/2047487314546825. Epub 2014 Aug 19.

Abstract

BACKGROUND

Previous cross-sectional surveys in different European countries within the EUROASPIRE programme demonstrated a high prevalence of modifiable risk factors, unhealthy lifestyles and inadequate drug treatment in coronary heart disease patients. Comparable data for ischaemic stroke patients is lacking.

METHODS

A stroke-specific study module was added to the EUROASPIRE III core survey. This cross-sectional multicentre survey included consecutive patients with first-ever ischaemic stroke from four European countries. Data were obtained from medical records, patient interviews and patient examinations within 6-36 months after the stroke event. Control of modifiable risk factors after stroke was evaluated against contemporary European guidelines.

RESULTS

A total of 881 patients was recruited. Median age was 66 years, 37.5% were female; average time from the stroke event to interview was 550 days. At the time of the interview, 17.6% of stroke patients smoked cigarettes, 35.5% had a body mass index ≥30 kg/m(2), 62.4% showed elevated blood pressure and 75.7% exhibited elevated LDL cholesterol levels. Antiplatelet drugs or oral anticoagulants were used by 87.2%, antihypertensive medication by 84.4% and statins by 56.8% of stroke patients. Among patients using antihypertensive drugs and lipid-lowering medication at the time of the interview, 34.3% and 34.4%, respectively, achieved target blood pressure and total cholesterol values according to current European guidelines.

CONCLUSION

The EUROASPIRE III stroke-specific module shows that secondary prevention and risk factor control in patients after ischaemic stroke need to be improved in four European centres at the time of the study since about half of patients are not achieving risk factor targets defined in European guidelines.

摘要

背景

欧洲动脉粥样硬化风险因素调查(EUROASPIRE)项目此前在不同欧洲国家开展的横断面调查显示,冠心病患者中可改变的风险因素、不健康生活方式及药物治疗不足的情况普遍存在。缺血性脑卒中患者的类似数据尚缺。

方法

在EUROASPIRE III核心调查中增加了一个针对脑卒中的研究模块。这项横断面多中心调查纳入了来自四个欧洲国家的首次发生缺血性脑卒中的连续患者。数据通过卒中事件发生后6至36个月内的病历、患者访谈及患者检查获取。根据当代欧洲指南评估卒中后可改变风险因素的控制情况。

结果

共招募了881例患者。中位年龄为66岁,女性占37.5%;从卒中事件到访谈的平均时间为550天。在访谈时,17.6%的卒中患者吸烟,35.5%的患者体重指数≥30 kg/m²,62.4%的患者血压升高,75.7%的患者低密度脂蛋白胆固醇水平升高。87.2%的卒中患者使用抗血小板药物或口服抗凝剂,84.4%的患者使用降压药物,56.8%的患者使用他汀类药物。在访谈时使用降压药物和降脂药物的患者中,分别有34.3%和34.4%根据当前欧洲指南达到了目标血压和总胆固醇值。

结论

EUROASPIRE III针对脑卒中的模块显示,在研究开展时,四个欧洲中心缺血性脑卒中患者的二级预防和风险因素控制需要改善,因为约一半的患者未达到欧洲指南定义的风险因素目标。

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