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该研究评估缺血性脑卒中后新发血管事件(NVE)的风险以及脑卒中不同亚型的血管风险。连续入选三级脑卒中研究中心(tertiary stroke center)的非致死性脑卒中患者1002例,随访2~5年[(31.0±15.9)月]。NVE根据动脉粥样硬化患者大型多中心注册研究[降低动脉粥样硬化血栓形成的持续健康登记(REACH)]的标准来定义,包括血管性死亡、非致死性脑卒中或心肌梗死、因其他动脉粥样硬化事件导致的住院等。脑卒中不同亚型根据急性脑卒中治疗Org10172试验(SSS-TOAST)的标准进行分型,分为心源性脑卒中、大动脉粥样硬化性脑卒中、小动脉疾病、其他病因引发的缺血性脑卒中、未确定病因的缺血性脑卒中。最终入选748例,162例出现NVE,发生率为0.084/人年。多因素回归分析结果显示,NVE风险与动脉粥样硬化程度(1、2个血管区域受影响)和3种脑卒中亚型[心源性脑卒中(HR2.58,95%CI 1.27~5.22)、大动脉粥样硬化性脑卒中(4.17,95%CI 2.03~8.56)、其他病因引发的缺血性脑卒中(5.70,95%CI 2.49~13.08)]相关。小动脉疾病和未确定病因的脑卒中NVE风险较低。总之,缺血性脑卒中患者NVE风险增加,脑卒中不同亚型的NVE风险不同。
The study assesses the risk of new vascular events (NVE) after ischemic stroke and the vascular risk of different subtypes of stroke. 1002 non-fatal stroke patients consecutively enrolled in the tertiary stroke center were followed up for 2 to 5 years [(31.0 ± 15.9) months]. NVE is defined by the criteria for a large, multicentre registry study of Atherosclerotic Atherosclerosis (Continued Health Registration for Atherothrombosis (REACH)], including vascular death, non-fatal stroke, or myocardial infarction due to other arteries In hospitalization due to atherothrombotic events. Different subtypes of stroke were classified according to criteria of the Org10172 trial of acute stroke (SSS-TOAST), and were categorized as cardiogenic stroke, major atherosclerotic stroke, arteriolar disease, and other causes of ischemic Stroke, ischemic stroke of unknown etiology. The final enrolled 748 cases, 162 cases of NVE, the incidence was 0.084 / person-year. Multivariable regression analysis showed that the risk of NVE was related to the degree of atherosclerosis (1,2 vascular regions affected) and three stroke subtypes (cardioembolic stroke (HR 2.58, 95% CI 1.27-5.22) , Major atherosclerotic stroke (4.17, 95% CI 2.03 ~ 8.56), ischemic stroke caused by other causes (5.70,95% CI 2.49 ~ 13.08)]. Stroke with arteriolar and undetermined causes has a lower risk of NVE. In conclusion, the risk of NVE is increased in ischemic stroke patients and the risk of NVE in different subtypes of stroke is different.