在 TIAregistry.org 中，亚洲患者和非亚洲患者的特征和结局存在差异。
Differences in Characteristics and Outcomes Between Asian and Non-Asian Patients in the TIAregistry.org.
机构信息
From the APHP, Department of Neurology and Stroke Center, Bichat Hospital, INSERM LVTS-U1148, DHU FIRE, Université Paris-Diderot, Sorbonne-Paris Cité, France (T.H., L.S., P.C.L., P-J.T., P.A.); Clinical Research Center for Medicine, International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan (S.U.); Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital (L.K.S.W.); Stanford Stroke Center, Department of Neurology and Neurological Sciences, Stanford University Medical Center, CA (G.W.A.); Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv University, Israel (N.M.B.); Cerebrovascular Disease Service, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA (L.R.C.); The Florey Institute of Neuroscience and Mental Health, the University of Melbourne, Parkville, VIC, Australia (G.A.D.); Department of Neurosciences, Hospital Santa Maria, University of Lisbon, Portugal (J.M.F.); Department of Neurology, Universitäts Medizin Mannheim, Heidelberg, Germany (M.G.H.); Université de Lille, CHU Lille, EA 2694-Santé publique: épidémiologie et qualité des soins, France (J.L.); Stroke Unit, Department of Neurology, Vall d'Hebron University Hospital, Universitat Autonoma de Barcelona, Spain (C.M.); Stroke Prevention Research Unit, Nuffield Department of Clinical Neuroscience, University of Oxford, United Kingdom (P.M.R.); APHP, Department of Cardiology, INSERM LVTS-U1148, DHU FIRE, Université Paris-Diderot, Sorbonne-Paris Cité, Hôpital Bichat, France, and NHLI Imperial College, ICMS Royal Brompton Hospital, London, United Kingdom (P.G.S.); APHP, Department of Biostatistics, Université Paris-Diderot, Sorbonne-Paris Cité, Fernand Widal Hospital, France (É.V.).
出版信息
Stroke. 2017 Jul;48(7):1779-1787. doi: 10.1161/STROKEAHA.117.016874. Epub 2017 Jun 5.
BACKGROUND AND PURPOSE
This study provides the contemporary causes and prognosis of transient ischemic attack (TIA) and minor stroke in Asians and the direct comparisons with non-Asians.
METHODS
The TIAregistry.org enrolled 4789 patients (1149 Asians and 3640 non-Asians) with a TIA or minor ischemic stroke within 7 days of onset. Every participating facility had systems dedicated to urgent intervention of TIA/stroke patients by specialists. The primary outcome was a composite of cardiovascular death, nonfatal stroke, and nonfatal acute coronary syndrome.
RESULTS
Approximately 80% of patients were evaluated within 24 hours of symptom onset. At 1 year, there were no differences in the rates of composite cardiovascular events (6.8% versus 6.0%; =0.38) and stroke (6.0% versus 4.8%; =0.11) between Asians and non-Asians. Asians had a lower risk of cerebrovascular disease (stroke or TIA) than non-Asians (adjusted hazard ratio, 0.79; 95% confidence interval, 0.63-0.98; =0.03); the difference was primarily driven by a lower rate of TIA in Asians (4.2% versus 8.3%; <0.001). Moderately severe bleeding was more frequent in Asians (0.8% versus 0.3%; =0.02). In multivariable analysis, multiple acute infarcts (=0.005) and alcohol consumption (=0.02) were independent predictors of stroke recurrence in Asians, whereas intracranial stenosis (<0.001), ABCD score (<0.001), atrial fibrillation (=0.008), extracranial stenosis (=0.03), and previous stroke or TIA (=0.03) were independent predictors in non-Asians.
CONCLUSIONS
The short-term stroke risk after a TIA or minor stroke was lower than expected when urgent evidence-based care was delivered, irrespective of race/ethnicity or region. However, the predictors of stroke were different for Asians and non-Asians.
背景与目的
本研究提供了亚洲人群中短暂性脑缺血发作（TIA）和小卒中的当代病因和预后，并与非亚洲人群进行了直接比较。
方法
TIAregistry.org 纳入了 4789 例 TIA 或小卒中发病 7 天内的患者（1149 例亚洲人，3640 例非亚洲人）。每个参与的机构都有专门的系统，由专家对 TIA/卒中患者进行紧急干预。主要结局是心血管死亡、非致死性卒中、非致死性急性冠脉综合征的复合结局。
结果
约 80%的患者在症状发作后 24 小时内得到评估。1 年后，亚洲人和非亚洲人复合心血管事件（6.8%与 6.0%；=0.38）和卒中（6.0%与 4.8%；=0.11）的发生率无差异。亚洲人发生脑血管疾病（卒中或 TIA）的风险低于非亚洲人（调整后的危险比，0.79；95%置信区间，0.63-0.98；=0.03）；这种差异主要归因于亚洲人 TIA 发生率较低（4.2%与 8.3%；<0.001）。亚洲人中度严重出血更常见（0.8%与 0.3%；=0.02）。多变量分析显示，多发急性梗死（=0.005）和饮酒（=0.02）是亚洲人卒中复发的独立预测因素，而颅内狭窄（<0.001）、ABCD 评分（<0.001）、房颤（=0.008）、颅外狭窄（=0.03）和既往卒中或 TIA（=0.03）是非亚洲人的独立预测因素。
结论
在提供紧急循证治疗后，TIA 或小卒中后的短期卒中风险低于预期，无论种族/民族或地区如何。然而，亚洲人和非亚洲人的卒中预测因素不同。
Zotero 插件