Department of Neurology, Soonchunhyang University Seoul Hospital, Soonchunhyang University School of Medicine, 59 Daesakwan-ro, Yong san-gu, Seoul 04401, Republic of Korea.
Department of Neurology, Soonchunhyang University Seoul Hospital, Soonchunhyang University School of Medicine, 59 Daesakwan-ro, Yong san-gu, Seoul 04401, Republic of Korea.
J Stroke Cerebrovasc Dis. 2022 Oct;31(10):106706. doi: 10.1016/j.jstrokecerebrovasdis.2022.106706. Epub 2022 Aug 17.
The purpose of this study was to determine whether underweight is associated with poststroke cardiovascular events and whether such association is different according to the presence of atrial fibrillation (AF).
Patients with acute stroke or transient ischemic attack who were prospectively registered in a multicenter stroke database from April 2008 to July 2020 were analyzed, excluding those aged 75 or older and those who were overweight. We prospectively captured major adverse cardiovascular events (MACE) within one year after stroke. Cox-proportional hazard regression analysis was conducted for each subgroup with or without AF after adjusting for predetermined vascular risk factors and potential confounders.
Among 30,912 patients, 1494 (4.8%) cases were underweight and 29,418 (95.2%) cases were normal weight. The cumulative event rate of 1-year MACE was higher in the underweight group (9.0%) than in the normal weight group (5.6%). In Cox-proportional regression, underweight was associated with significantly higher MACE (adjusted hazard ratio [HR]: 1.62, 95% confidence interval [CI]: 1.26-2.09) and recurrent stroke (adjusted HR: 1.42, 95% CI: 1.02-1.98) in all study patients. In patients with AF, the risk of MACE for the underweight group was not significantly increased. In contrast, in patients without AF, the underweight group had a consistently higher risk of MACE (adjusted HR: 1.66, 95% CI: 1.25-2.22) and recurrent stroke (adjusted HR: 1.50, 95% CI: 1.05-2.14).
Underweight increased the risk of MACE and recurrent stroke within one year after acute stroke, especially in stroke without AF.
本研究旨在确定体重过轻是否与卒中后心血管事件相关，以及这种关联是否因是否存在心房颤动（AF）而不同。
分析了 2008 年 4 月至 2020 年 7 月期间在一个多中心卒中数据库中前瞻性登记的急性卒中和短暂性脑缺血发作患者，排除了 75 岁及以上和超重患者。我们前瞻性地捕获了卒中后 1 年内的主要不良心血管事件（MACE）。在调整了预先确定的血管危险因素和潜在混杂因素后，对有或无 AF 的每个亚组进行 Cox 比例风险回归分析。
在 30912 例患者中，1494 例（4.8%）为体重过轻，29418 例（95.2%）为正常体重。体重过轻组的 1 年 MACE 累积发生率（9.0%）高于正常体重组（5.6%）。在 Cox 比例风险回归中，体重过轻与所有研究患者的 MACE（调整后的危险比[HR]：1.62，95%置信区间[CI]：1.26-2.09）和复发性卒中（调整后的 HR：1.42，95% CI：1.02-1.98）显著相关。在伴有 AF 的患者中，体重过轻组发生 MACE 的风险并未显著增加。相比之下，在不伴有 AF 的患者中，体重过轻组的 MACE（调整后的 HR：1.66，95% CI：1.25-2.22）和复发性卒中（调整后的 HR：1.50，95% CI：1.05-2.14）风险持续较高。
体重过轻会增加急性卒后 1 年内 MACE 和复发性卒中的风险，尤其是在不伴有 AF 的卒中患者中。
