Wańkowicz Paweł, Nowacki Przemysław, Gołąb-Janowska Monika
Department of Neurology, Pomeranian Medical University, Szczecin, Poland.
Arch Med Sci. 2019 Apr 5;17(1):19-24. doi: 10.5114/aoms.2019.84212. eCollection 2021.
Atrial fibrillation (AF) is the most common heart arrhythmia. The condition is known to increase the risk of ischemic stroke (IS). Classical risk factors for the development of AF include advanced age, hypertension, diabetes mellitus, coronary heart disease and lipid metabolism disorders. Importantly, these are also recognized risk factors for ischemic stroke. Therefore, the purpose of this study was to investigate AF risk factors in patients with IS.
This is single-centre retrospective study which included 696 patients with acute ischemic stroke and nonvalvular atrial fibrillation and 1678 patients with acute ischemic stroke without atrial fibrillation.
In this study we found - based on a univariable and multivariable logistic regression model - that compared to the patients with IS without AF, the group of patients which suffered from IS with nonvalvular atrial fibrillation (NVAF) had a higher proportion of patients who smoked cigarettes (OR = 15.742, < 0.01; OR = 41.1, < 0.01), had hypertension (OR = 5.161, < 0.01; OR = 5.666, < 0.01), history of previous stroke (OR = 3.951, < 0.01; OR = 4.792, < 0.01), dyslipidemia (OR = 2.312, < 0.01; OR = 1.592, < 0.01), coronary heart disease (OR = 2.306, < 0.01; OR = 1.988, < 0.01), a greater proportion of female patients (OR = 1.717, < 0.01; OR = 2.095, < 0.01), higher incidence of diabetes mellitus (OR = 1.341, < 0.01; OR = 1.261, = 0.106) and more patients in old age (OR = 1.084, < 0.01; OR = 1.101, < 0.01).
Our study demonstrates a need for thorough and systematic monitoring of post-ischemic stroke patients in whom AF has not been detected and who display other important risk factors. Regardless of the stroke, these factors may be responsible for development of AF.
心房颤动(AF)是最常见的心律失常。已知该病症会增加缺血性中风(IS)的风险。AF发生的经典风险因素包括高龄、高血压、糖尿病、冠心病和脂质代谢紊乱。重要的是,这些也是公认的缺血性中风风险因素。因此,本研究的目的是调查IS患者的AF风险因素。
这是一项单中心回顾性研究,纳入了696例急性缺血性中风合并非瓣膜性心房颤动患者和1678例急性缺血性中风无心房颤动患者。
在本研究中,我们基于单变量和多变量逻辑回归模型发现,与无AF的IS患者相比,患有非瓣膜性心房颤动(NVAF)的IS患者组中吸烟患者比例更高(OR = 15.742,<0.01;OR = 41.1,<0.01)、患有高血压(OR = 5.161,<0.01;OR = 5.666,<0.01)、有既往中风史(OR = 3.951,<0.01;OR = 4.792,<0.01)、血脂异常(OR = 2.312,<0.01;OR = 1.592,<0.01)、冠心病(OR = 2.306,<0.01;OR = 1.988,<0.01)、女性患者比例更高(OR = 1.717,<0.01;OR = 2.095,<0.01)、糖尿病发病率更高(OR = 1.341,<0.01;OR = 1.261,= 0.106)以及老年患者更多(OR = 1.084,<0.01;OR = 1.101,<0.01)。
我们的研究表明,对于未检测到AF且存在其他重要风险因素的缺血性中风后患者,需要进行全面系统的监测。无论中风情况如何,这些因素可能是AF发生的原因。