Int J Cardiol:治疗后残留赘生物的感染性心内膜炎患者发生卒中和心内膜炎复发的风险

2019-06-23 xing.T MedSci原创

由此可见,与没有残留赘生物的患者相比,残留赘生物>5mm的IE存活患者的卒中风险增加。这些研究结果为一组很少被描述的患者群体提供了新的观点,表明在残留赘生物>5mm的存活IE患者中潜在的治疗益处。

对于出院时残留赘生物存活的感染性心内膜炎(IE)患者,随后的卒中风险和IE复发知之甚少。

近日,心血管领域权威杂志International Journal of Cardiology上发表了一篇研究文章,从2002年到2012年,患者被连续纳入东丹麦心内膜炎登记中心。研究人员只纳入了在IE入院期间接受治疗并且活着出院的患者。通过超声心动图评估出院时残留赘生物的大小,并根据残留赘生物的中位数长度对患者进行分类。研究人员使用多变量调整的Cox比例风险分析评估了研究组之间相关的卒中风险和IE复发。

在915名IE患者中,应用选择标准后纳入305例,151例无残留赘生物,73例残留1-5mm赘生物,81例残留>5mm的赘生物。研究人员发现,与无残留赘生物患者相比,1-5mm和>5mm残留赘生物患者的卒中相关风险增加,分别有HR=0.88(95%CI:0.26-2.94)和HR=2.95(95%CI:1.18-7.34)。与无残留赘生物患者相比,1-5mm和>5mm残留赘生物患者对于IE复发相关风险,各组间无差异,分别有HR=1.39(95%CI:0.91-2.13)和HR=1.38(95%CI:0.91-2.10)。 

由此可见,与没有残留赘生物的患者相比,残留赘生物>5mm的IE存活患者的卒中风险增加。这些研究结果为一组很少被描述的患者群体提供了新的观点,表明在残留赘生物>5mm的存活IE患者中潜在的治疗益处。 

原始出处:

Østergaard,et al.Residual vegetation after treatment for left-sided infective endocarditis and subsequent risk of stroke and recurrence of endocarditis.International Journal of Cardiology.2019.https://doi.org/10.1016/j.ijcard.2019.06.059

本文系梅斯医学(MedSci)原创编译整理,转载需授权!

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    2019-06-23 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

    0