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染色体异常与心房颤动和缺血性卒发生率:一项全国范围内基于人群的研究。

Chromosomal abnormalities and atrial fibrillation and ischemic stroke incidence: a nationwide population-based study.

机构信息

Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.

Heart Research Institute, Cardiovascular-Arrhythmia Center, College of Medicine, Chung-Ang University Hospital, Seoul, Republic of Korea.

出版信息

Sci Rep. 2020 Sep 28;10(1):15872. doi: 10.1038/s41598-020-72678-0.

Abstract

There is a paucity of information as to whether chromosomal abnormalities, including Down Syndrome, Turner Syndrome, and Klinefelter Syndrome, have an association with atrial fibrillation (AF) and ischemic stroke development. Data from 3660 patients with Down Syndrome, 2408 with Turner Syndrome, and 851 with Klinefelter Syndrome without a history of AF and ischemic stroke were collected from the Korean National Health Insurance Service (2007-2014). These patients were followed-up for new-onset AF and ischemic stroke. Age- and sex-matched control subjects (at a ratio of 1:10) were selected and compared with the patients with chromosomal abnormalities. Down Syndrome patients showed a higher incidence of AF and ischemic stroke than controls. Turner Syndrome and Klinefelter Syndrome patients showed a higher incidence of AF than did the control group, but not of stroke. Multivariate Cox regression analysis revealed that three chromosomal abnormalities were independent risk factors for AF, and Down Syndrome was independently associated with the risk of stroke. In conclusion, Down Syndrome, Turner Syndrome, and Klinefelter Syndrome showed an increased risk of AF. Down Syndrome patients only showed an increased risk of stroke. Therefore, AF surveillance and active stroke prevention would be beneficial in patients with these chromosomal abnormalities.

摘要

目前关于染色体异常(包括唐氏综合征、特纳综合征和克氏综合征)与心房颤动(AF)和缺血性卒中发展之间是否存在关联的信息较少。从韩国国家健康保险服务(2007-2014 年)中收集了 3660 例唐氏综合征患者、2408 例特纳综合征患者和 851 例无 AF 和缺血性卒中病史的克氏综合征患者的数据。这些患者随访新发生的 AF 和缺血性卒中。选择了年龄和性别匹配的对照组(比例为 1:10),并与染色体异常患者进行了比较。唐氏综合征患者的 AF 和缺血性卒中发生率高于对照组。特纳综合征和克氏综合征患者的 AF 发生率高于对照组,但卒中发生率没有增加。多变量 Cox 回归分析显示,三种染色体异常是 AF 的独立危险因素,唐氏综合征与卒中风险独立相关。总之,唐氏综合征、特纳综合征和克氏综合征的 AF 风险增加。唐氏综合征患者仅显示卒中风险增加。因此,在这些染色体异常患者中进行 AF 监测和积极的卒中预防将是有益的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63e0/7522243/56efbb6936f6/41598_2020_72678_Fig1_HTML.jpg

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