■目前的指南指出,对于隐源性缺血性卒中(IS)或短暂性脑缺血发作(TIA)患者,应进行长期心律监测以筛查房颤。本研究旨在评估符合此类调查条件的隐源性IS/TIA的发生率,并估计每年整个法国可能相关的患者人数。
■所有隐源性急性IS/TIA病例,35岁,均从以人群为基础的第戎中风登记处检索,法国(2013-2020年)。符合长期心律监测条件的患者在排除住院或在前30天内死亡的患者后被定义。或先前存在重大减值。按年龄组和性别计算合格隐源性IS/TIA的年发病率。法国符合条件的患者总数通过年龄和性别特异性发病率的标准化来估计。
■在DijonStrokeRegistry中记录的2811名IS/TIA患者中,1239患有隐源性IS/TIA,其中1045人符合长期心律监测的条件(517IS和528TIA,平均年龄73.6±14.6岁,55.4%女性)。在总体性别中,符合条件的隐源性IS/TIA的粗发病率为每年169/100,000(95%CI:159-179),IS每年83/100,000(95%CI:76-91),TIA每年85/100,000(95%CI:78-93)。在法国,有资格进行长期心律监测的隐源性IS/TIA患者总数估计为66,125(95%CI:65,622-66,630),其中包括32,764(95%CI:32,410-33,120)与IS和33,361(95%CI:33,004-33,721)与TIA。
■这项研究表明,隐源性IS/TIA的发生率很高,符合长期心律监测的条件。国家层面的估计指出,大量患者可能需要进行此类房颤筛查,关注护理网络的组织和相关费用。
UNASSIGNED: Current guidelines indicate prolonged cardiac rhythm monitoring for atrial fibrillation screening in patients with cryptogenic ischemic stroke (IS) or transient ischemic attack (TIA). This study aimed to assess the incidence of cryptogenic IS/TIA eligible for such investigation, and to estimate the number of patients potentially concerned in whole France annually.
UNASSIGNED: All cryptogenic acute IS/TIA cases ⩾35 years old were retrieved from the population-based Dijon Stroke Registry, France (2013-2020). Patients eligible for prolonged cardiac rhythm monitoring were defined after excluding those who died in-hospital or within the first 30 days, or with preexisting major impairment. Annual incidence rates of eligible cryptogenic IS/TIA were calculated by age groups and sex. The total number of eligible patients in France was estimated by standardization to age- and sex-specific incidence.
UNASSIGNED: Among 2811 IS/TIA patients recorded in the Dijon Stroke Registry, 1239 had cryptogenic IS/TIA of whom 1045 were eligible for prolonged cardiac rhythm monitoring (517 IS and 528 TIA, mean age 73.6 ± 14.6 years old, 55.4% women). Crude incidence rates of eligible cryptogenic IS/TIA were 169/100,000 per year (95% CI: 159-179) in overall sexes, 83/100,000 per year (95% CI: 76-91) for IS, and 85/100,000 per year (95% CI: 78-93) for TIA. The total number of patients with cryptogenic IS/TIA eligible for prolonged cardiac rhythm monitoring in France was estimated to be 66,125 (95% CI: 65,622-66,630) for the calendar year 2022, including 32,764 (95% CI: 32,410-33,120) with IS and 33,361 (95% CI: 33,004-33,721) with TIA.
UNASSIGNED: This study demonstrated a high incidence of cryptogenic IS/TIA eligible for prolonged cardiac rhythm monitoring. Estimates at a national level pointed out the large number of patients who may require access to such atrial fibrillation screening, with attention to be paid on regarding organization of care networks and related costs.