TY -的T1 -效应共存的血管疾病复发的长期风险事件后TIA或中风JF -神经学乔-神经病学SP - e695 LP - e707做- 10.1212 / WNL。首页0000000000007935六世- 93 - 7非盟-马里昂雅盟井巷李盟——肖恩·里昂盟——尼古拉·g·洛维特盟马格达莱纳河m . Kubiak AU -露易丝银盟Emmanuel Touze AU -彼得·m·罗斯韦尔盟代表牛津血管研究Y1 - 2019/08/13 UR - //www.ez-admanager.com/content/93/7/e695.abstract N2 -目的确定TIA患者或缺血性中风与心血管疾病(即共存。首页、历史的冠状动脉和外周动脉疾病)仍在高风险的复发性缺血性事件尽管目前二级预防指南。英国牛津郡在以人群为基础的研究方法(牛津血管的研究),我们研究了连续TIA或缺血性中风患者为2002 - 2014。根据当前的二级预防患者治疗指南和我们确定冠状动脉事件的风险,复发性缺血性中风,和主要出血分层的存在共存的心血管疾病。结果在2555例患者(9148(后续),那些(n = 640;25.0%)同时患有心血管疾病(449只冠状;103年外围;88)都是10年冠状动脉事件的风险比那些没有更高(22.8%,95%置信区间17.4 - -27.9;vs 7.1%, 5.3 - -8.8;p & lt;0.001; age- and sex-adjusted hazard ratio [HR] 3.07, 2.24–4.21) and of recurrent ischemic stroke (31.5%, 25.1–37.4; vs 23.4%, 20.5–26.2; p = 0.0049; age- and sex-adjusted HR 1.23, 0.99–1.53), despite similar rates of use of antithrombotic and lipid-lowering medication. However, in patients with noncardioembolic TIA/stroke, risk of extracranial bleeds was also higher in those with coexisting cardiovascular disease, particularly in patients aged <75 years (8.1%, 2.8–13.0; vs 3.4%, 1.6–5.3; p = 0.0050; age- and sex-adjusted HR 2.71, 1.16–6.30), although risk of intracerebral hemorrhage was not increased (age- and sex-adjusted HR 0.36, 0.04–2.99).Conclusions As in older studies, patients with TIA/stroke with coexisting cardiovascular disease remain at high risk of recurrent ischemic events despite current management. More intensive lipid-lowering might therefore be justified, but benefit from increased antithrombotic treatment might be offset by the higher risk of extracranial bleeding.DWI=diffusion-weighted imaging; HR=hazard ratio; LDL=low-density lipoprotein; MI=myocardial infarction; N-STEMI=non-ST-elevation; OXVASC=Oxford Vascular Study; PCSK-9=proprotein convertase subtilisin/kexin type 9; STEMI=ST-elevation; TOAST=Trial of Org 10172 in Acute Stroke Treatment ER -
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