中国卒中杂志 ›› 2014, Vol. 9 ›› Issue (03): 252-361.
李姝雅,王伊龙,王拥军
收稿日期:
2013-10-04
出版日期:
2014-03-20
发布日期:
2014-03-20
通讯作者:
王拥军
y o n g j u nwa n g 1 9 6 2@
gmail.com
Received:
2013-10-04
Online:
2014-03-20
Published:
2014-03-20
摘要:
【摘要】 心房颤动是临床上常见的心律失常,其患病率随着年龄增长而增加。由于无症状性心房颤 动的存在,心房颤动发病率及患病率均不完善。心房颤动因并发缺血性卒中而具有很高的致残率、致 死率。口服抗凝药是目前预防心房颤动血栓栓塞并发症最有效的方法。近年来,随着心房颤动发病 率的日益增长及缺血性卒中病因研究的逐渐细化,伴心房颤动的缺血性卒中相关研究引起了学界的广 泛关注。本文就相关研究热点做一综述。
李姝雅,王伊龙,王拥军. 心房颤动相关缺血性卒中的研究进展[J]. 中国卒中杂志, 2014, 9(03): 252-361.
LI Shu-Ya, WANG Yi-Long,WANG Yong-Jun.. Developments in Ischemic Stroke with Atrial Fibrillation[J]. Chinese Journal of Stroke, 2014, 9(03): 252-361.
参考文献1 Feinberg WM, Blackshear JL, Laupacis A, et al.Prevalence, age, distribution and gender of patientswith atrial fibrillation:analysis and implications[J].Arch Intern Med, 1995, 155:469-473.2 Go AS, Hylek EM, Phillips KA, et a1. Prevalenceof diagnosed atrial fibrillation in adults:nationalimplications for rhythm management and strokeprevention:the Anticoagulation and Risk Factors inAtrial Fibrillation (ATRIA) Study[J]. JAMA, 2001,295:2370-2375.3 Har t RG, Halper in JL. At r ial f ibr illation andthromboembolism:a decade of progross in strokeprevention[J]. Ann Intem Med, 1999, 131:688-695.4 Winter Y, Wolfram C, Schaeg M, et al. Evaluation ofcosts and outcome in cardioembolic stroke or TIA[J].J Neurol, 2009, 256:954-963.5 Schneck M, Lei X. Cardioembolic stroke[J/OL]. eMedNeurol, 2008.6 Bruggenjurgen B, Rossnagel K, Roll S, et al. Theimpact of atrial fibrillation on the cost of stroke:Theberlin acute stroke study[J]. Value Health, 2007,10:137-143. ht t p: //eme d ic i ne.me d s c ap e.com/article/1160370-overview.7 Jorgensen HS, Nakayama H, Reith J, et a1. Acutestroke with atrial fibrillation. The Copenhagen StrokeStudy[J]. Stroke, 1996, 27:1765-1769.8 Marini C, De Santis F, Sacco S, et a1. Contributionof atrial fibrillation to incidence and outcome ofischemic stroke:results from a population-basedstudy[J]. Stroke, 2005, 36:1115-1119.9 Steger C, Pratter A, Martinek-Bregel M, et a1. Strokepatients with atrial fibrillation have a worse prognosisthan patients without:data from the Austrian Strokeregistry[J]. Eur Heart J, 2004, 25:1734-1740.10 Wann LS, Curtis AB, January CT, et al. 2011 ACCF/AHA/HRS focused update on the management ofpatients with atrial fibrillation (updating the 2006guideline):A report of the American College ofCardiology Foundation/American Heart Associationtask force on practice guidelines[J]. Circulation, 2011,123:104-123.11 Connolly S, Pogue J, Hart RP, et al. Clopidogrelplus aspirin versus oral anticoagulation for atrialfibrillation in the atrial fibrillation clopidogrel trialwith irbesartan for prevention of vascular events(active w):A randomised controlled trial[J]. Lancet,2006, 367:1903-1912.12 Nieuwlaat R, Capucci A, Lip GY, et al. Euro HeartSurvey Investigators. Antithrombotic treatment inreal-life atrial fibrillation patients:a report from theEuro Heart Survey on Atrial Fibrillation[J]. Eur HeartJ, 2006, 27:3018-3026.13 Reynolds MW, Fahrbach K, Hauch O, et al. Warfarinanticoagulation and outcomes in patients with atrialfibrillation:A systematic review and meta analysis[J].Chest, 2004, 126:1938-1945.14 [No authors listed]. Risk factors for stroke andefficacy of antithrombotic therapy in atrial fibrillation.Analysis of pooled data from f ive randomizedcontrolled trials[J]. Arch Intern Med, 1994, 154:1449-1457.15 Stroke Prevention in Atrial Fibrillation Investigators.Risk factors for thromboembolism during aspirintherapy in patients with atrial fibrillation:The StrokePrevention in Atrial Fibrillation Study[J]. J StrokeCerebrovasc Dis, 1995, 5:147-157.16 van Latum JC, Koudstaal PJ, Venables GS, et al.Algra A for the European Atrial Fibrillation Trial(EAFT) Study Group. Predictors of major vascularevents in patients with a transient ischemic attackor minor ischemic stroke with nonrheumatic atrialfibrillation[J]. Stroke, 1995, 16:801-806.17 Wang TJ, Massaro JM, Levy D, et al. A risk scorefor predicting stroke or death in individuals withnew-onset atrial fibrillation in the community:TheFramingham heart study[J]. JAMA, 2003, 290:1049-1056.18 National Collaborating Centre for Chronic Conditions.Atrial Fibrillation:National Clinical Guideline forManagementin Primary and Secondary Care[M].London:Royal College of Physicians, 2006.19 Fuster V, Ryden LE, Cannom DS, et al. ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation-executive summary:A report ofthe American College of Cardiology/American HeartAssociation task force on practice guidelines andthe European Society of Cardiology committee forpractice guidelines (writing committee to revise the2001 guidelines for the management of patients withatrial fibrillation)[J]. Eur Heart J, 2006, 27:1979-2030.20 Singer DE, Albers GW, Dalen JE, et al; AmericanCollege of Chest Physicians. Antithrombotic therapyin atrial fibrillation:American College of ChestPhysicians evidence-basedclinical practice guidelines(8th edition) [J]. Chest, 2008, 133:546S-592S.21 Reitbrock S, Heeley E, Plumb J, et al. Chronic atrialfibrillation:incidence, prevalence and predictionof st roke using the Congest ive hea r t failu re,Hypertension, Age>75, Diabetes mellitus, and priorStroke or transient ischemic attack (CHADS2) riskstratification scheme[J]. Am Heart J, 2008, 156:57-64.22 Gage BF, Waterman AD, Shannon W, et al. Validationof clinical classification schemes for predictingstroke:Results from the national registry of atrialfibrillation[J]. JAMA, 2001, 285:2864-2870.23 Lip GY, Nieuwlaat R, Pisters R, et al. Refiningclinical risk stratification for predicting stroke andthromboembolism in atrial fibrillation using a novelrisk factor-based approach:The Euro Heart Survey onatrial fibrillation[J]. Chest, 2010, 137:263-272.24 Keogh C, Wallace E, Dillon C, et al. Validation of theCHADS2 clinical prediction rule to predict ischaemicstroke. A systematic review and meta-analysis[J].Thromb Haemost, 2011, 106:528-538.25 Olesen JB, Lip GY, Hansen ML, et al. Validationof risk stratification schemes for predicting strokeand th romboembolism in pat ient s with at r ialfibrillation:Nationwide cohort study[J]. BMJ, 2011,342:d124.26 Lip GY, Frison L, Halperin JL, et al. Identifyingpatients at high risk for stroke despite anticoagulation:A comparison of contemporary stroke riskstratification schemes in an anticoagulated atrialfibrillation cohort[J]. Stroke, 2010, 41:2731-2738.27 Lip GY, Lim HS. Atrial f ibrillation and strokeprevention[J]. Lancet Neurol, 2007, 6:981-993.28 Baruch L, Gage BF, Horrow J, et al. Can patients atelevated risk of stroke treated with anticoagulants befurther risk stratified[J]. Stroke, 2007, 38:2459-2463.29 Mant J, Hobbs FD, Fletcher K, et al. Warfarin versusaspirin for stroke prevention in an elderly communitypopulation with atrial fibrillation (the BirminghamAtrial Fibrillation Treatment of the Aged Study,BAFTA):A randomised controlled trial[J]. Lancet,2007, 370:493-503.30 Fang MC, Go AS, Chang Y, et al. A new risk schemeto predict warfarin-associated hemor rhage:TheATRIA (Anticoagulation and Risk Factors in AtrialFibrillation) study[J]. J Am Coll Cardiol, 2011, 58:395-401.31 Eikelboom JW, Wallentin L, Connolly SJ, et al. Riskof bleeding with 2 doses of dabigatran compared withwarfarin in older and younger patients with atrialfibrillation. An analysis of the Randomized Evaluationof Long-Term Anticoagulant Therapy (RE-LY)Trial[J]. Circulation, 2011, 123:2363-2372.32 ROCKET AF Study Investigators. Rivaroxabanoncedaily, oral, direct factor Xa inhibition comparedwith vitamin K antagonism for prevention of strokeand embolism trial in atrial fibrillation:Rationaleand design of the ROCKET AF study[J]. Am Heart J,2010, 159:340-347, e341.33 Hankey GJ, Patel MR, Stevens SR, et al. Rivaroxabancompared with warfarin in patients with atrialfibrillation and previous stroke or transient ischaemicattack:A subgroup analysis of ROCKET AF[J]. LancetNeurol, 2012, 11:315-322.34 Stuart JC, John E, Campbell J, et al. Apixaban inpatients with atrial fibrillation[J]. N Engl J Med, 2011,364:806-817.35 Granger CB, Alexander JH, Mcmurray JJ, et al.Apixaban versus warfarin in patients with atrialfibrillation[J]. N Engl J Med, 2011, 365:981-992.36 Beyth RJ, Qui m LM, Landefeld CS. Prospectiveevaluation of an index for predicting the risk of majorbleeding in outpatients treated with warfarin[J]. Am JMed, 1998, 105:91-99.37 Kuijer PM, Hutten BA, Prins MH, et a1. Prediction ofthe risk of bleeding during anticoagulant treatment forvenous thromboembolism[J]. Arch Intern Med, 1999,159:457-460.38 Shireman TI, Mahnken JD, Howard PA, et al.Development of a contemporary bleeding risk modelfor elderly warfarin recipients[J]. Chest, 2006,130:1390-1396.39 Gage BF, Yan Y, Milligan PE, et a1. Clinicalc l a s s i f i c a t i o n s c h e m e s f o r p r e d i c t i n ghemorrhage:results from the National Registry ofAtrial Fibrillation (NRAF)[J]. Am Heart J, 2006,151:713-719.40 Pisters R, Lane DA, Nieuwlaat R, et al. A novel userfriendlyscore (HAS-BLED) to assess 1-year risk ofmajor bleeding in patients with atrial fibrillation:TheEuro Heart Survey[J]. Chest, 2010, 138:1093-1100.41 Romero-Ortuno R, O'Shea D. Aspirin versus warfarin in atrial fibrillation:Decision analysis may helppatients' choice[J]. Age Ageing, 2012, 41:250-254.42 Fang MC, Go AS, Chang Y, et al. A new risk schemeto predict warfarin-associated hemorrhage:The ATRIA(Anticoagulation and Risk Factors in Atrial Fibrillation)study[J]. J Am Coll Cardiol, 2011, 58:395-401.43 Apostolakis S, Lane DA, Guo Y, et al. Performance ofthe hemorrhages, atria, and HAS-BLED bleeding riskpredictionscores in patients with atrial fibrillationu nde rgoi ng a nt icoag ul at ion:The AMADEUS(evaluating the use of sr34006 compared to warfarinor acenocoumarol in patients with atrial fibrillation)study[J]. J Am Coll Cardiol, 2012, 60:861-867.44 Lip GY. Stroke and bleeding risk assessment in atrialfibrillation:When, how, and why?[J]. Eur Heart J,2013, 34:1041-1049.45 Lip GY, Lin HJ, Hsu HC, et al. Compa rat iveassessment of the HAS-BLED score with otherpublished bleeding r isk scor ing schemes, forint racranial haemor rhage r isk in a non-at r ialfibrillation population:The Chin-Shan communitycohort study[J]. Int J Cardiol, 2013, 168:1832-1836.46 Roldan V, Marin F, Fernandez H, et al. Predictiveva lue of t he HAS-BLED a nd a t r i a ble e d i ngscores for the risk of serious bleeding in a "realworld"population with atrial fibrillation receivinganticoagulant therapy[J]. Chest, 2013, 143:179-184.47 Camm AJ, Kirchhof P, Lip GY, et a1. Guidelines forthe management of atrial fibrillation:the task force forthe management of atrial fibrillation of the EuropeanSociety of Cardiology (ESC)[J]. Eur Heart J, 2010,31:2369-2429.48 Ca i r n s JA, Cormol ly S, MeMu r t r y S, e t a1.Canadian Cardiovascular Society atrial fibrillationguidelines 2010:prevention of stroke and systemicthromboembolism in atrial fibrillation and flutter[J].Can J Cardiol, 2011, 27:74-90.49 Paciaroni M, Agnelli G, Micheli S, et al. Efficacyand safety of anticoagulant treatment in acutecardioembolic stroke:A meta-analysis of randomizedcontrolled trials[J]. Stroke, 2007, 38:423-430.50 Taya AH, Tian M, Kelly KM, et al. Atrial fibrillationdetected by mobile cardiac outpatient telemetryin cryptogenic TIA or stroke[J]. Neurology, 2008,71:1696-1701.51 D o u e n AG , P a g e a u N , Me d i c S . S e r i a lelectrocardiographic assessments signif icantlyimprove detection of atrial fibrillation 2.6-fold inpatients with acute stroke[J]. Stroke, 2008, 39:480-482.52 Kamel H, Hegde M, Johnson DR, et al. Costeffectivenessof outpatient cardiac monitoring todetect atrial fibrillation after ischemic stroke[J].Stroke, 2010, 41:1514-1520.53 Stahrenberg R, Weber-Kruger M, Seegers J, et al.Enhanced detection of paroxysmal atrial fibrillationby early and prolonged continuous holter monitoringin patients with cerebral ischemia presenting in sinusrhythm[J]. Stroke, 2010, 41:2884-2888.54 Cotter PE, Martin PJ, Ring L, et al. Incidence of atrialfibrillation detected by implantable loop recorders inunexplained stroke[J]. Neurology, 2013, 80:1546-1550.55 Suissa L, Bertora D, Lachaud S, et al. Score forthe Targeting of Atrial Fibrillation (STAF):a newapproach to the detection of atrial fibrillation in thesecondary prevention of ischemic stroke[J]. Stroke,2009, 40:2866-2868.56 Suissa L, Mahagne MH, Lachaud S. Score for thetargeting of atrial f ibrillation:A new approachto diagnosing paroxysmal atrial f ibrillation[J].Cerebrovasc Dis, 2011, 31:442-447.57 Horstmann S, Rizos T, Guntner J, et al. Does theSTAF score help detect paroxysmal atrial fibrillationin acute stroke patients?[J]. Eur J Neurol, 2013, 20:147-152.58 Malik S, Hicks WJ, Schultz L, et al. Development ofa scoring system for atrial fibrillation in acute strokeand transient ischemic attack patients:The LADSscoring system[J]. J Neurol Sci, 2011, 301:27-30.59 Suissa L, Lachaud S, Mahagne MH. Optimal timingand duration of continuous electrocardiographicmonitoring for detecting atrial fibrillation in strokepatients[J]. J Stroke Cerebrovasc Dis, 2013, 22:991-995.60 Ritter MA, Kochhauser S, Duning T, et al. Occultatrial fibrillation in cryptogenic stroke:Detection by7-day electrocardiogram versus implantable cardiacmonitors[J]. Stroke, 2013, 44:e135.61 Hong HJ, Kim YD, Cha MJ, et al. Early neurologicaloutcomes according to CHADS2 score in strokepatients with non-valvular atrial fibrillation[J]. Eur JNeurol, 2012, 19:284-290.62 Sato S, Yazawa Y, Itabashi R,et al. Pre-admissionCHADS2 score is related to severity and outcome ofstroke[J]. J Neurol Sci, 2011, 307:149-152.63 Giralt-Steinhauer E, Cuadrado-Godia E, Ois A, etal. CHA2DS2_VASc score and prognosis in ischemicstrokes with atrial fibrillation[J]. J Neurol, 2012,259:745-751.64 Ntaios G, Lip GY, Makaritsis K, et al. CHADS2,CHA2DS2_VASc, and long-term stroke outcome inpatients without atrial fibrillation[J]. Neurology, 2013,80:1009-1017.65 Saposnik G, Kapral MK, Liu Y, et al. iScore:A riskscore to predict death early after hospitalization for anacute ischemic stroke[J]. Circulation, 2011, 123:739-749.66 Saposnik G, Raptis S, Kapral MK, et al. The iScorepredicts poor functional outcomes early af terhospitalization for an acute ischemic stroke[J]. Stroke,2011, 42:3421-3428.67 Saposnik G, Demchuk A, Tu JV, et al. The iScorepredicts efficacy and risk of bleeding in the nationalinstitute of neurological disorders and stroke tissueplasminogen activator stroke trial[J]. J StrokeCerebrovasc Dis, 2012, 22:876-882.68 Saposnik G, Fang J, Kapral MK, et al. The iScorepredicts effectiveness of thrombolytic therapy foracute ischemic stroke[J]. Stroke, 2012, 43:1315-1322.69 O'Donnell MJ, Fang J, D'Uva C, et al. The PLANscore:A bedside prediction rule for death and severedisability following acute ischemic stroke[J]. ArchIntern Med, 2012, 172:1548-1556.70 Smith EE, Shobha N, Dai D, et al. Risk score forin-hospital ischemic stroke mortality derived andvalidated within the get with the guidelines-strokeprogram[J]. Circulation, 2010, 122:1496-1504.71 Ntaios G, Faouzi M, Ferrari J, et al. An integer-basedscore to predict functional outcome in acute ischemicstroke:The ASTRAL score[J]. Neurology, 2012,78:1916-1922.72 Muscari A, Puddu GM, Santoro N, et al. A simplescoring system for outcome prediction of ischemicstroke[J]. Acta Neurol Scand, 2011, 124:334-342.73 Ovbiagele B, Liebeskind DS, Kim D, et al. Prognosticvalue of Framingham cardiovascular risk score inhospitalized stroke patients[J]. J Stroke CerebrovascDis, 2011, 20:222-226.74 Huxley RR, Lopez FL, Folsom AR, et al. Absoluteand at t r ibut able r isks of at r ial f ibr illat ion inrelation to optimal and borderline risk factors:TheAtherosclerosis Risk In Communities (ARIC) study[J].Circulation, 2011, 123:1501-1508.75 Yusuf S, Healey JS, Pogue J, et al. Irbesartan inpatients with atrial fibrillation[J]. N Engl J Med, 2011,364:928-938. |
[1] | 曹黎明, 任力杰. 急性缺血性卒中诊疗技术的进展与展望[J]. 中国卒中杂志, 2024, 19(9): 983-989. |
[2] | 符鹏程, 曹黎明, 朱佳倩, 赵桂玉, 徐格林. 大动脉粥样硬化性缺血性卒中再灌注治疗的研究进展[J]. 中国卒中杂志, 2024, 19(9): 1004-1011. |
[3] | 张丽苹, 曹黎明, 肖楠, 廖雨琦, 池枫, 余艳妮, 任力杰. 纳米材料在缺血性卒中诊疗中的研究进展及挑战[J]. 中国卒中杂志, 2024, 19(9): 1012-1017. |
[4] | 王晓蕊, 骆嵩, 邹良玉, 屈洪党, 崔雪, 赵玉洁. 嗜酸性粒细胞与单核细胞比值预测急性缺血性卒中患者静脉溶栓预后的价值研究 [J]. 中国卒中杂志, 2024, 19(9): 1025-1033. |
[5] | 王铄, 余苹, 张宁, 王春雪. 2013—2023年缺血性卒中与睡眠相关性研究的文献计量学分析 [J]. 中国卒中杂志, 2024, 19(9): 1040-1047. |
[6] | 周宏宇, 李子孝, 王拥军. 基于影像组学预测大脑年龄与缺血性卒中的研究进展[J]. 中国卒中杂志, 2024, 19(9): 1066-1076. |
[7] | 阿娜古丽·阿不拉尼压孜, 吴晓欣, 李骄星, 李竹浩, 盛文利. 急性缺血性卒中磁敏感血管征影响因素及临床应用的研究进展[J]. 中国卒中杂志, 2024, 19(9): 1077-1085. |
[8] | 杨金波, 张聪. 高分辨率血管壁成像在缺血性卒中患者中的应用进展[J]. 中国卒中杂志, 2024, 19(9): 1086-1093. |
[9] | 吴春艳, 尹雅诗, 王广志, 岳奎涛. 急性缺血性卒中不同时间窗影像学评价及应用进展[J]. 中国卒中杂志, 2024, 19(9): 1094-1101. |
[10] | 张梦若, 徐守臣, 隋翠翠, 李玉奎, 王雪莉. 下肢康复机器人联合头针治疗对老年缺血性卒中患者步行效率和协调功能影响调查 [J]. 中国卒中杂志, 2024, 19(8): 902-908. |
[11] | 吴娱倩, 张玉梅, 臧大维, 范小伟, 王安心, 张晓丽, 孟霞. 上肢动作研究测试量表评定亚急性期缺血性卒中患者偏瘫侧上肢及手功能的信效度和敏感性研究 [J]. 中国卒中杂志, 2024, 19(8): 915-923. |
[12] | 莫秋红, 丁晓波, 李靓, 张岩波, 李伟荣. 基于可解释性机器学习模型的轻型缺血性卒中复发预测研究[J]. 中国卒中杂志, 2024, 19(8): 924-930. |
[13] | 逯丹, 陈玮琪, 王雅平, 段婉莹, 郭蕾, 王玲, 刘丽萍, 徐安定, 王拥军, 中国卒中学会脑保护圆桌会学术委员会. 缺血性卒中脑细胞保护科学声明——来自中国卒中学会的科学声明 [J]. 中国卒中杂志, 2024, 19(8): 938-955. |
[14] | 李光硕, 赵性泉. 《中国急性缺血性卒中诊治指南2023》解读[J]. 中国卒中杂志, 2024, 19(8): 956-961. |
[15] | 白磊鹏, 罗杰, 周思捷, 黄健辉, 梁铭钦, 赵庆顺. 肺叶楔形切除术后并发急性缺血性卒中行介入取栓治疗2例并文献回顾 [J]. 中国卒中杂志, 2024, 19(8): 962-966. |
阅读次数 | ||||||
全文 |
|
|||||
摘要 |
|
|||||