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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Detection of Atrial Fibrillation After Stroke and the Risk of Recurrent Stroke
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Detection of Atrial Fibrillation After Stroke and the Risk of Recurrent Stroke

机译：检测中风后心房颤动和复发性卒中的风险

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Failure to expeditiously diagnose atrial fibrillation (AF) as the cause of ischemic stroke has unclear consequences. We studied the association between detection of AF after discharge and the risk of recurrent stroke. We followed a prospectively assembled cohort of patients hospitalized for stroke for 1 year for new diagnoses of AF and recurrent stroke. We compared rates of recurrent stroke in patients with a new diagnosis of AF and those without a new diagnosis of AF after discharge using Kaplan, Meier survival statistics. We conducted Cox proportional hazards analysis of the diagnosis and timing of AF and recurrent stroke after adjustment for age, sex, race, preexisting AF, hypertension, dyslipidemia, diabetes, previous stroke, and use of antithrombotic and statin medications. Among 5575 patients with stroke, 113 (2.0%) received a new diagnosis of AF after discharge, and 221 (4.0%) had recurrent stroke. At 1 year, the Kaplan-Meier rate of recurrent stroke was 18.9% in those with a new diagnosis of AF and 4.5% in others, including those with AF diagnosed before or during the index hospitaliza-tion (P = .001). The association between a new diagnosis of AF and stroke recurrence persisted after adjustment for potential confounders (hazard ratio, 5.6; 95% confidence interval, 3.4-9.1). A new diagnosis of AF after discharge for stroke is associated with an increased risk of recurrent stroke, even compared with patients with known AF. These findings identify a subset of patients at high risk for recurrent stroke and highlight the importance of timely detection of AF in patients with stroke.
机译：由于缺血性中风的原因，未能迅速地诊断心房颤动（AF）对后果不明确。我们研究了出院后检测AF之间的关联和复发性卒中的风险。我们遵循一年前期组装的患者患者，为新的AF和反复性卒中的新诊断。我们对患者的患者进行了复发性中风的比较了使用Kaplan，Meier Survival Statistics在出院后对AF的新诊断和那些没有新的AF诊断。我们对AF，性别，种族，预先存在的AF，高血压，血脂血症，糖尿病，先前中风以及使用抗血栓形成和他汀类药物的使用后，对AF和反复性卒中的诊断和时序进行了COX比例危害的分析。在5575例中风患者中，113名（2.0％）接受了放电后的AF诊断，221（4.0％）具有复发性卒中。在1年后，复发性中风的Kaplan-Meier率为18.9％，在其它AF和4.5％的新诊断中，包括在指数住院期间或期间诊断的人（P = .001）。在调整潜在混淆后持续存在于AF和中风复发的新诊断之间的关联（危险比，5.6; 95％置信区间，3.4-9.1）。甚至与已知AF的患者相比，脑卒中后排出后的AF的新诊断与复发性卒中的风险增加有关。这些发现鉴定了患者高风险的患者的副本，并突出了及时检测卒中患者AF的重要性。

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