Department of Cardiology, First Affiliated Hospital of Dalian Medical University.
Institute of Cardiovascular, First Affiliated Hospital of Dalian Medical University.
Int Heart J. 2021 Mar 30;62(2):312-319. doi: 10.1536/ihj.20-611. Epub 2021 Mar 6.
This study aims to evaluate the incidence of ischemic stroke or transient ischemic attack (TIA) based on CHADS-VASc scores in non-AF Chinese patients with sinus rhythm.We used health check-up data of 101,510 participants from the Kailuan Cohort Study. Participants' risk levels were defined by their CHADS-VASc scores (range 0-3): Men with scores of 0, 1, or ≥ 2 and women with scores of 1, 2, or ≥ 3 were considered at low, intermediate, or high risk, respectively. Cox proportional hazards model was used to assess the association between the CHADS-VASc-determined risk and the incidence of ischemic stroke/TIA.The mean 7.5 year follow-up examination revealed 2968 ischemic strokes/TIA events. The incidence rates for ischemic stroke/TIA events in men and women were 3.8% and 1.5%, respectively. The incidence of ischemic stroke/TIA increased with elevated predicted risks based on CHADS-VASc scores in men: 2.2% for low-risk, 4.1% for intermediate-risk, and 7.8% for high-risk groups (P < 0.001 for trend). The incidences of ischemic stroke/TIA also increased with elevated predicted risks in women: 0.8% for low-risk, 2.1% for intermediate-risk, and 5.0% for high-risk groups (P < 0.001 for trend). Compared with low-risk group, the crude hazard ratio (95% confidence interval) of ischemic stroke/TIA for men in moderate- and high-risk groups were 1.96 (1.79-2.14; P < 0.001) and 4.18 (3.81-4.57; P < 0.001). Similar findings were observed in women.Risks of ischemic stroke/TIA events was high, particularly among those with high CHADS-VASc scores.
本研究旨在评估窦性心律非房颤中国患者基于 CHADS-VASc 评分的缺血性卒中和短暂性脑缺血发作（TIA）发生率。我们使用了来自开滦队列研究的 101510 名参与者的健康检查数据。参与者的风险水平由 CHADS-VASc 评分（范围 0-3）确定：男性评分 0、1 或≥2，女性评分 1、2 或≥3，分别被认为处于低、中、高风险。Cox 比例风险模型用于评估 CHADS-VASc 确定的风险与缺血性卒中和 TIA 发生率之间的关系。平均 7.5 年的随访检查显示 2968 例缺血性卒中和 TIA 事件。男性和女性缺血性卒中和 TIA 事件的发生率分别为 3.8%和 1.5%。随着 CHADS-VASc 评分预测风险的升高，男性缺血性卒中和 TIA 的发生率也随之增加：低危组为 2.2%，中危组为 4.1%，高危组为 7.8%（趋势 P<0.001）。女性的缺血性卒中和 TIA 发生率也随着预测风险的升高而增加：低危组为 0.8%，中危组为 2.1%，高危组为 5.0%（趋势 P<0.001）。与低危组相比，中危和高危组男性缺血性卒中和 TIA 的粗危险比（95%置信区间）分别为 1.96（1.79-2.14；P<0.001）和 4.18（3.81-4.57；P<0.001）。女性也观察到了类似的发现。缺血性卒中和 TIA 事件的风险较高，尤其是 CHADS-VASc 评分较高的患者。
