未经授权:本研究旨在探讨肥厚型心肌病(HCM)患者急性缺血性卒中的院内转归。
未经评估:使用来自全国住院患者样本的加权出院数据,我们在2011年至2017年期间,在患有HCM的成年患者中确定了5804例非选择性的缺血性卒中住院治疗.为了比较,采用简单随机抽样方法选择58,179例没有HCM的成年患者因缺血性卒中住院作为对照。
UNASSIGNED:与没有HCM的患者相比,HCM患者的高脂血症患病率较高(62.4%vs57.5%,分别,P<.001)和慢性心力衰竭(25.4%vs13.6%,分别,P<.001),但糖尿病患病率较低(28.2%vs34.9%,分别,P<.001)和高血压(42.9%vs53.4%,分别,P<.001)。记录了45.1%(n=2617)的HCM患者的心房颤动。然而,这些患者中只有28.0%(n=733)长期使用抗凝剂.HCM患者的院内死亡率为6.3%(n=368),显着高于无HCM的患者(4.1%,P<.001)。具有HCM(赔率比[OR],1.35;P<.001),心房颤动(OR,2.08;P<.001),和慢性心力衰竭(或,1.65;P<.001)是院内死亡的重要预测因素。在存活出院的HCM患者中,50.0%的人被转移到熟练的护理机构,而没有HCM的人为45.3%(P<.001)。
未经证实:患有HCM的急性缺血性卒中患者的预后比没有HCM的患者差。这些发现强调了积极治疗HCM患者中风的诱发因素的重要性,尤其是心房颤动。
UNASSIGNED: To investigate the in-hospital outcomes of acute ischemic stroke in patients with hypertrophic cardiomyopathy (HCM).
UNASSIGNED: Using weighted discharge data from the National Inpatient Sample, we identified 5804 nonelective hospitalizations for ischemic stroke in adult patients with HCM between 2011 and 2017. For comparison, 58,179 hospitalizations for ischemic stroke in adult patients without HCM were selected as controls using the simple random sampling method.
UNASSIGNED: Compared with the patients without HCM, those with HCM had a higher prevalence of hyperlipidemia (62.4% vs 57.5%, respectively, P<.001) and chronic heart failure (25.4% vs 13.6%, respectively, P<.001) but a lower prevalence of diabetes (28.2% vs 34.9%, respectively, P<.001) and hypertension (42.9% vs 53.4%, respectively, P<.001). Atrial fibrillation was documented in 45.1% (n=2617) of the patients with HCM. However, only 28.0% (n=733) of these patients had long-term use of anticoagulants. The in-hospital death rate among the patients with HCM was 6.3% (n=368), which was significantly higher than that in the patients without HCM (4.1%, P<.001). Having HCM (odds ratio [OR], 1.35; P<.001), atrial fibrillation (OR, 2.08; P<.001), and chronic heart failure (OR, 1.65; P<.001) were significant predictors of in-hospital death. In patients with HCM who were discharged alive, 50.0% were transferred to skilled nursing facilities compared with 45.3% of those without HCM (P<.001).
UNASSIGNED: The prognosis of acute ischemic stroke is worse in patients with HCM than in those without HCM. These findings emphasize the importance of aggressive treatment of predisposing factors for stroke in patients with HCM, especially atrial fibrillation.