Beijing Institute of Basic Medical Sciences, 27 Taiping Road, Beijing 100850, China; Academy of Military Medical Sciences, 27 Taiping Road, Beijing 100850, China.
John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans 70121, LA, USA.
Prog Cardiovasc Dis. 2024 Sep-Oct;86:96-99. doi: 10.1016/j.pcad.2024.09.005. Epub 2024 Sep 18.
Stroke is a leading cause of death and disability worldwide, with diverse comorbidities that influence its clinical outcomes. However, a comprehensive understanding of the short- and long-term patterns of stroke-related comorbidities remains limited. To address this gap, we conducted a disease-wide association study (DWAS) to systematically explore the landscape of stroke comorbidities in a population-based cohort. Using data from the FinnGen cohort, which included 337,194 participants and 27,496 ischemic stroke cases, we analyzed 1,757 medical events as potential stroke comorbidities. We employed Cox proportional hazards regression, adjusting for sex and age, to identify significant associations between stroke and these medical events. Comorbidities were classified into pre- and post-stroke categories, and their temporal patterns were analyzed over a 1- to 15-year follow-up period. Our findings revealed that stroke comorbidities span multiple disease taxonomies, with significant enrichment in the circulatory, digestive, and musculoskeletal systems. Notably, the study identified distinct pre-stroke and post-stroke comorbidities that persist or evolve over time, supporting the concept of a disease continuum. These temporal patterns suggest that stroke risk and outcomes are shaped by sequential comorbidities rather than simultaneous occurrences. This study provides the most comprehensive profile of stroke comorbidities to date, highlighting the interconnected nature of diseases. By mapping the progression of comorbidities across time and disease categories, DWAS offers valuable insights for early intervention and long-term treatment. Our findings emphasize the importance of viewing stroke as part of a broader disease continuum, offering new opportunities for prevention, diagnosis, and treatment strategies tailored to individual risk profiles.
中风是全球范围内导致死亡和残疾的主要原因，其临床结果受多种合并症的影响。然而，对于中风相关合并症的短期和长期模式，我们的理解仍然有限。为了弥补这一空白，我们进行了一项全疾病关联研究（DWAS），以系统地探索基于人群的队列中中风合并症的全貌。利用 FinnGen 队列的数据，该队列包含 337194 名参与者和 27496 例缺血性中风病例，我们分析了 1757 种可能的中风合并症作为潜在的合并症。我们采用 Cox 比例风险回归，调整了性别和年龄，以确定中风与这些医疗事件之间的显著关联。合并症被分为中风前和中风后两类，并在 1 至 15 年的随访期间分析了它们的时间模式。我们的研究结果表明，中风合并症跨越了多个疾病分类，在循环、消化和肌肉骨骼系统中存在显著富集。值得注意的是，该研究确定了独特的中风前和中风后合并症，这些合并症随着时间的推移持续存在或演变，支持疾病连续体的概念。这些时间模式表明，中风风险和结果是由序贯合并症而不是同时发生的合并症所塑造的。这项研究提供了迄今为止最全面的中风合并症概况，突出了疾病之间的相互关联性质。通过在时间和疾病分类上绘制合并症的进展，DWAS 为早期干预和长期治疗提供了有价值的见解。我们的研究结果强调了将中风视为更广泛疾病连续体的一部分的重要性，为针对个体风险概况量身定制的预防、诊断和治疗策略提供了新的机会。
