Wang Wen-Hwa
Department of Cardiology, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan.
Health Management Center, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan.
J Clin Med. 2022 Apr 11;11(8):2120. doi: 10.3390/jcm11082120.
The cardiac etiology of acute ischemic stroke (AIS) plays an important role in young adults; therefore, complete cardiac workups and subsequent prevention methods are important for treating young AIS patients. However, the definition of a young age for AIS patients could be below 45 years old, while in some previous studies, it has been below 55 years old. It remains unclear whether cardiac workups are equally important for AIS patients in the young (the age of 20-45 years old) and middle-aged (46-55 years old) categories.
This prospective study included 103 patients admitted due to a first AIS attack younger than 55 years old during the period from 1 October 2018 to 31 December 2020. All the patients received cardiologist consultations and cardiac workups accordingly. The characteristics of patients, cardiac workups, clinical findings, and management were analyzed.
AIS patients in the 46-55-year-old group had a higher prevalence of hypertension (61.4% vs. 39.0%), diabetes mellitus (27.3% vs. 15.3%), a previous history of coronary artery disease (9.1% vs. 1.7%), and atrial fibrillation (9.1% vs. 1.7%) compared to the 20-45-year-old group. After cardiologist consultations, a higher prevalence of newly diagnosed coronary artery disease (6.8% vs. 1.7%) and congestive heart failure (11.4% vs. 1.7%) was noted. Both groups disclosed similar percentages of patent foramen ovale (PFO) (27.3% vs. 22.0%) and valvular disease. These results led to subsequent changes in treatment in both groups. The 20-45-year-old group had higher percentages of receiving PFO occluders (11.9%) compared to the 46-55-year-old group (6.8%).
Cardiologist consultations with thorough cardiac workups for AIS patients can reveal many cardiac findings in both young and middle-aged patients. This leads to a subsequent change in treatment, including medical and surgical aspects, which are important as secondary prevention for AIS.
急性缺血性卒中（AIS）的心脏病因在年轻成年人中起着重要作用；因此，全面的心脏检查及后续预防方法对于治疗年轻AIS患者至关重要。然而，AIS患者的年轻年龄定义可能是45岁以下，而在一些先前的研究中，该定义为55岁以下。目前尚不清楚心脏检查对于年轻（20 - 45岁）和中年（46 - 55岁）AIS患者是否同样重要。
这项前瞻性研究纳入了2018年10月1日至2020年12月31日期间因首次AIS发作入院的103例年龄小于55岁的患者。所有患者均接受了心脏病专家的会诊并相应地进行了心脏检查。对患者的特征、心脏检查、临床发现及治疗进行了分析。
与20 - 45岁组相比，46 - 55岁组的AIS患者高血压患病率更高（61.4%对39.0%）、糖尿病患病率更高（27.3%对15.3%）、有冠状动脉疾病病史的比例更高（9.1%对1.7%）以及心房颤动比例更高（9.1%对1.7%）。在心脏病专家会诊后，新诊断出的冠状动脉疾病患病率更高（6.8%对1.7%）以及充血性心力衰竭患病率更高（11.4%对1.7%）。两组卵圆孔未闭（PFO）和瓣膜病的比例相似（27.3%对22.0%）。这些结果导致两组的治疗均发生了后续变化。20 - 45岁组接受PFO封堵器治疗的比例（11.9%）高于46 - 55岁组（6.8%）。
对AIS患者进行心脏病专家会诊并进行全面的心脏检查，在年轻和中年患者中均可发现许多心脏问题。这会导致后续治疗的改变，包括药物和手术方面，这对于AIS的二级预防很重要。
