Yan Xinsheng, Lian Shuwen, Wang Dong, Yan Bao, Zhang Litao, Zhang Zhenlu
Department of Clinical Laboratory, Wuhan Asia General Hospital Affiliated to Wuhan University of Science and Technology, 430056 Wuhan, Hubei, China.
Department of Clinical Laboratory, Chengdu Aerotropolis Asia Heart Hospital, 610500 Chengdu, Sichuan, China.
Rev Cardiovasc Med. 2025 Apr 23;26(4):26992. doi: 10.31083/RCM26992. eCollection 2025 Apr.
The association between stroke history and clinical events after valve replacement in patients with atrial fibrillation (AF) combined with valvular heart disease (VHD) is unclear. Thus, we sought to investigate the relationship between stroke history and clinical events in patients with AF after valve replacement.
This retrospective cohort study enrolled 746 patients with AF who underwent valve replacement between January 2018 and December 2019 at the Wuhan Asia Heart Hospital. Patient information was collected from the hospital's electronic medical record system. Patients were categorized based on their stroke history and followed through outpatient visits or by telephone until the occurrence of an endpoint event; the maximum follow-up period was 24 months. Endpoint events included thrombotic events, bleeding, and all-cause mortality. The frequency of thrombotic, hemorrhagic, and fatal events during the follow-up period was compared between the two groups. Independent risk factors for endpoint events were analyzed using multifactorial Cox regression.
The analysis included 746 patients. Over a 24-month follow-up period, there were more total adverse events (hazard ratio (HR) = 2.08, 95% confidence interval (CI) 1.06-4.08, = 0.018), thrombotic events (HR = 10.28, 95% CI 2.85-37.11, < 0.001), and increased all-cause mortality (HR = 5.74, 95% CI 1.84-17.93, < 0.001) in the stroke history group than in the non-stroke history group. Fewer bleeding events were observed in the group with a history of stroke (HR = 0.87, 95% CI 0.37-2.04, = 0.757). A multifactorial Cox regression analysis revealed that a personal history of stroke was an independent risk factor for total adverse events, thrombotic events, and all-cause mortality.
Previous stroke history is significantly associated with adverse events in AF patients following valve replacement.
心房颤动（AF）合并心脏瓣膜病（VHD）患者中风病史与瓣膜置换术后临床事件之间的关联尚不清楚。因此，我们试图研究AF患者中风病史与瓣膜置换术后临床事件之间的关系。
这项回顾性队列研究纳入了2018年1月至2019年12月在武汉亚洲心脏病医院接受瓣膜置换术的746例AF患者。患者信息从医院电子病历系统中收集。根据患者的中风病史进行分类，并通过门诊随访或电话随访，直至发生终点事件；最长随访期为24个月。终点事件包括血栓形成事件、出血和全因死亡率。比较两组随访期间血栓形成、出血和致命事件的发生频率。采用多因素Cox回归分析终点事件的独立危险因素。
分析纳入746例患者。在24个月的随访期内，有中风病史组的总不良事件（风险比（HR）=2.08，95%置信区间（CI）1.06 - 4.08，P = 0.018）、血栓形成事件（HR = 10.28，95% CI 2.85 - 37.11，P < 0.001）和全因死亡率增加（HR = 5.74，95% CI 1.84 - 17.93，P < 0.001）均多于无中风病史组。有中风病史组的出血事件较少（HR = 0.87，95% CI 0.37 - 2.04，P = 0.757）。多因素Cox回归分析显示，个人中风病史是总不良事件、血栓形成事件和全因死亡率的独立危险因素。
既往中风病史与AF患者瓣膜置换术后不良事件显著相关。
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