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胸部 X 光片上观察到的主动脉弓钙化可能是复发性中风的独立预测指标。

Aortic Arch Calcification Observed on Chest X-Ray May Serve as an Independent Predictor for Recurrent Stroke.

机构信息

Çerkezköy State Hospital, Tekirdağ - Turquia.

Baskent University Faculty of Medicine - Alanya Application And Research Center, Antalya - Turquia.

出版信息

Arq Bras Cardiol. 2024 Jun;121(7):e20230805. doi: 10.36660/abc.20230805.

Abstract

BACKGROUND

Despite advances in diagnostic and treatment modalities, there is a need for predictive markers for recurrent strokes.

OBJECTIVES

This study aimed to investigate the relationship between aortic arch calcification (AAC) and stroke recurrence in stroke patients during a one-year follow-up.

METHODS

All stroke patients who experienced their first event were evaluated for participation in the study. Patients who experienced recurrent strokes during the one-year follow-up were recorded. AAC was assessed by chest radiography. Based on the occurrence of recurrent strokes the patients were divided into two groups. AAC was classified into four categories according to its degree, and the presence of AAC was included in the statistical analysis. The relationship between AAC and recurrent stroke was assessed using a receiver operating characteristic curve. A significance level of <0.05 was deemed acceptable for all statistical analyses.

RESULTS

A total of 203 patients were included in the study (46.8% female, mean age 69±12.3). Recurrent stroke was detected in 49 patients. AAC, hypertension, and atrial fibrillation were more frequent in patients with recurrent stroke. Patients with recurrent stroke had a lower glomerular filtration rate and a higher red cell distribution width (RDW). In multivariate regression analysis, AAC (hazard ratio [HR], 3.544; 95% CI:1.653-7.598, p=0.001) and RDW (HR,1.214; 95% CI:1.053-1.400, p=0.008) were identified as independent predictors of recurrent stroke.

CONCLUSION

The presence of AAC (≥ grade 1) and RDW were found to be significantly associated with the development of recurrent stroke within one year. These findings may have prognostic significance in the follow-up of stroke patients.

摘要

背景

尽管诊断和治疗方法有了进步,但仍需要预测复发性中风的标志物。

目的

本研究旨在探讨主动脉弓钙化(AAC)与中风患者一年内复发中风的关系。

方法

所有经历首次发病的中风患者均评估参与研究。记录在一年内随访期间经历复发性中风的患者。通过胸部 X 线摄影评估 AAC。根据复发性中风的发生情况,将患者分为两组。根据其严重程度将 AAC 分为四级,并将 AAC 的存在纳入统计分析。使用受试者工作特征曲线评估 AAC 与复发性中风之间的关系。所有统计分析均接受<0.05 的显著性水平。

结果

共有 203 例患者纳入研究(46.8%为女性,平均年龄 69±12.3 岁)。49 例患者检测到复发性中风。复发性中风患者的 AAC、高血压和心房颤动更为常见。复发性中风患者的肾小球滤过率较低,红细胞分布宽度(RDW)较高。在多变量回归分析中,AAC(风险比[HR],3.544;95%置信区间:1.653-7.598,p=0.001)和 RDW(HR,1.214;95%置信区间:1.053-1.400,p=0.008)被确定为复发性中风的独立预测因子。

结论

存在 AAC(≥1 级)和 RDW 与一年内复发性中风的发生显著相关。这些发现可能对中风患者的随访具有预后意义。

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