国家神经系统疾病临床医学研究中心数据管理与共享系统
Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Atrial Fibrillation is Associated with CSVD and Prognosis in Patients with Ischemic Stroke
第一作者：Yicong Wang
通讯作者：Yilong Wang
基本信息
- 负责人：Yicong Wang
- 数据来源： CNSR-Ⅲ
- 论文编号：CNSR-Ⅲ20230202
- 发表时间：2024-10-23
2024-10-23
已发表文章
发表杂志：CNS Neurosci Ther
发表类型: Original Research Article
影响因子(IF): 4.8
PMID: PMC11491548 Pubmed原文链接 全文下载
主要研究背景及目的
Acute ischemic stroke has the characteristics of high incidence rate, high disability rate and high mortality rate, which has a strong burden on families and society. Atrial fibrillation is one of the key risk factors for stroke and the leading cause of cardiac embolism, with some patients having poor prognosis. CSVD has many imaging signs such as high white matter hyperintensities, lacunes, microbleeds, perivascular space, and cerebral atrophy, which have a profound impact on the patient's bowel movements, emotions, gait, and other aspects. It has been proved that there is correlation between cerebrovascular disease, intracranial atherosclerosis and stroke prognosis. This study further explores the interaction between atrial fibrillation, imaging phenotype of cerebral small vessel disease, and stroke prognosis, providing guidance for clinical work.
方法
The study data was from the Third China National Stroke Registry (CNSR-III), which is a nationwide, multicenter, prospective registry of acute ischemic cerebrovascular events including TIA and ischemic stroke in China. Based on medical history and auxiliary examinations, we determine the diagnosis of atrial fibrillation (AF). Five imaging markers including lacunes, white matter hyperintensity (WMH), cerebral microbleeds (CMBs) and perivascular spaces (PVS)，atrophy as well as the CSVD burden score and modified CSVD burden score were assessed. Logistic regression or ordinal logistic regression models with odds ratios (OR) or common odds ratio (cOR) were used to estimate the relationship between AF, CSVD and 12-month outcomes.
结论
Among Chinese patients with acute ischemic stroke, those with AF were associated with a higher risk of 12-month mortality and stroke recurrence. When AF was combined with some CSVD imaging features such as lacunes, WMH, presence of CMBs or burdens, the 12-month poor prognosis worsened.
主要结果
The average age was 62.40 ± 11.22 years old, and 8362 (68.65%) were men at baseline. Patients with AF had an increased risk of stroke recurrence and all-cause mortality at 12-month follow-up. Those with AF and CSVD imaging such as lacunes, white matter hyperintensity (WMH), and the presence of cerebral microbleeds (CMBs) had an increased risk of poor prognosis. And those with both AF and CSVD burden had an increased risk of worse prognosis at 12-month follow-up.