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短暂性脑缺血发作或轻度缺血性卒中的远期生存率和血管事件风险:一项队列研究
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作者 Van Wijk I. kappelle l. j. +2 位作者 Van Gijn j. A. Algra 朱冰坡 《世界核心医学期刊文摘(心脏病学分册)》 2005年第11期29-30,共2页
Background: Determinants of survival and of risk of vascular events after transient ischaemic attack(TIA) or minor ischaemic stroke are not well defined in the long term. We aimed to restudy these risks in a prospecti... Background: Determinants of survival and of risk of vascular events after transient ischaemic attack(TIA) or minor ischaemic stroke are not well defined in the long term. We aimed to restudy these risks in a prospective cohort of patients after TIA or minor ischaemic stroke(Rankin grade≤3), after 10 years or more. Methods: We assessed the survival status and occurrence of vascular events in 2473 participants of the Dutch TIA Trial(recruitment in 1986-89; arterial cause of cerebral ischaemia). We included 24 hospitals in the Netherlands that recruited at least 50 patients. Primary outcomes were all-cause mortality and the composite event of death from all vascular causes, non-fatal stroke, and non-fatal myocardial infarction. We assessed cumulative risks by Kaplan-Meier analysis and prognostic factors with Cox univariate and multivariate analysis. Findings: Follow-up was complete in 2447(99%) patients. After a mean follow-up of 10.1 years, 1489(60%) patients had died and 1336(54%) had had at least one vascular event. 10-year risk of death was 42.7%(95%CI 40.8-44.7). Age and sex-adjusted hazard ratios were 3.33(2.97-3.73) for age over 65 years, 2.10(1.79-2.48) for diabetes, 1.77(1.45-2.15) for claudication, 1.94(1.42-2.65) for previous peripheral vascular surgery, and 1.50(1.31-1.71) for pathological Q waves on baseline electrocardiogram. 10-year risk of a vascular event was 44.1%(42.0-46.1). After falling in the first 3 years, yearly risk of a vascular event increased over time. Predictive factors for risk of vascular events were similar to those for risk of death. Interpretation: Long-term secondary prevention in patients with cerebral ischaemia still has room for further improvement. 展开更多
关键词 缺血性卒中 远期生存率 队列研究 事件风险 脑缺血患者 非致死性卒中 全因死亡 二级预防 中评估 分级评分
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