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 not uncommon among patients with ischemic stroke and transient ischemic stroke in china
第一作者：Xiaomeng Yang
基本信息
- 负责人：Xiaomeng Yang
- 数据来源： Crist
- 论文编号：CRIST20190046
- 发表时间：2017-09-02
2017-09-02
已发表文章
主要研究背景及目的
Atrial fibrillation (AF) is reported to be a less frequent cause of ischemic stroke in China than in Europe and North America, but it is not clear whether this is due to underestimation. Our aim was to define the true frequency of AF-associated stroke, to determine the yield of 6-day Holter ECG to detect AF in Chinese stroke patients, and to elucidate predictors of newly detected AF.
方法
Patients with acute ischemic stroke or transient ischemic attack (TIA) were enrolled in a prospective, multicenter cohort study of 6-day Holter monitoring within 7 days after stroke onset at 20 sites in China between 2013 and 2015. Independent predictors of newly-detected AF were determined by multivariate analysis.
结论
Contrary to previous reports, AF-associated stroke is frequent (20%) in China if systemically sought. Prolonged noninvasive cardiac rhythm monitoring importantly increases AF detection in patients with recent ischemic stroke and TIA in China. Advanced age, history of heart failure, and higher admission NIHSS and higher level of HDL were independent indicators of newly-detected AF.
主要结果
Among 1511 patients with ischemic stroke and TIA (mean age 63 years, 33.1% women), 305 (20.2%) had either previously known (196, 13.0%) or AF newly-detected by electrocardiography (53, 3.5%) or by 6-day Holter monitoring (56/1262, 4.4%). A history of heart failure (OR = 4.70, 95%CI, 1.64–13.5), advanced age (OR = 1.06, 95%CI, 1.04–1.09), NIHSS at admission (OR = 1.06, 95%CI, 1.02–1.10), blood high density lipoprotein (HDL) (OR = 1.52, 95%CI, 1.09–2.13), together with blood triglycerides (OR = 0.64, 95%CI, 0.45–0.91) were independently associated with newly-detected AF.