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【JACC】主动脉粥样硬化、血液高凝状态与卒中的
Aortic Atherosclerosis, Hypercoagulability, and Stroke
The APRIS (Aortic Plaque and Risk of Ischemic Stroke) Study
abstract：
Background: Atherosclerotic plaques in the aortic arch are a risk factor for ischemic stroke. Their relationship with blood hypercoagulability, which might enhance their embolic potential and affect treatment and prevention, is not known.
Methods: We performed transesophageal echocardiography in 255 patients with first acute ischemic stroke and in 209 control subjects matched by age, gender, and race/ethnicity. The association between arch plaques and hypercoagulability, and its effect on the stroke risk, was assessed with a case-control design. Stroke patients were then followed prospectively to assess recurrent stroke and death.
Results: Large (4 mm) arch plaques were associated with increased stroke risk (adjusted odds ratio [OR]: 2.4, 95% confidence interval [CI]: 1.3 to 4.6), especially when ulcerations or superimposed thrombus were present (adjusted OR: 3.3, 95% CI: 1.4 to 8.2). Prothrombin fragment F 1.2, an indicator of thrombin generation, was associated with large plaques in stroke patients (p = 0.02), but not in control subjects. Over a mean follow-up of 55.1 ± 37.2 months, stroke patients with large plaques and F 1.2 over the median value had a significantly higher risk of recurrent stroke and death than those with large plaques but lower F 1.2 levels (230 events per 1,000 person-years vs. 85 events per 1,000 person-years; p = 0.05).
Conclusions: In patients presenting with acute ischemic stroke, large aortic plaques are associated with blood hypercoagulability, suggesting a role for coagulation activation in the stroke mechanism. Coexistence of large aortic plaques and blood hypercoagulability is associated with an increased risk of recurrent stroke and death
来源：
http://content.onlinejacc.org/cgi/content/abstract/52/10/855 本人已认领本文翻译48小时未提交请其他战友继续认领 Aortic Atherosclerosis, Hypercoagulability, and Stroke
主动脉粥样硬化、血液高凝状态与卒中的关系
The APRIS (Aortic Plaque and Risk of Ischemic Stroke) Study
主动脉斑块与缺血性卒中研究
abstract：
Background: Atherosclerotic plaques in the aortic arch are a risk factor for ischemic stroke.
研究背景：主动脉弓处动脉粥样斑块是缺血性卒中的危险因素。
Their relationship with blood hypercoagulability, which might enhance their embolic potential and affect treatment and prevention, is not known.
血液高凝状态可增加血栓形成风险，并影响治疗和预防，而两者与血液高凝状态间的关系尚不清楚。
Methods: We performed transesophageal echocardiography in 255 patients with first acute ischemic stroke and in 209 control subjects matched by age, gender, and race/ethnicity.
方法：我们对初次急性缺血性卒中患者255名及其年龄、性别和种族匹配的对照者209名进行了经食管超声心动图检查。
The association between arch plaques and hypercoagulability, and its effect on the stroke risk, was assessed with a case-control design.
利用病例对照研究分析主动脉弓斑块与高凝状态的关系及其对卒中危险的影响。
Stroke patients were then followed prospectively to assess recurrent stroke and death.
并前瞻性的随访卒中患者，评估再发卒中和死亡。
Results: Large (4 mm) arch plaques were associated with increased stroke risk (adjusted odds ratio [OR]: 2.4, 95% confidence interval [CI]: 1.3 to 4.6), especially when ulcerations or superimposed thrombus were present (adjusted OR: 3.3, 95% CI: 1.4 to 8.2).
结果：大的主动脉弓斑块（4mm）是增加卒中的危险因素（调整后的OR值：2.4，95％的可信区间为：1.3-4.6），尤其是存在糜烂或附壁血栓时（（调整后的OR值：3.3，95％的可信区间为：1.4-8.2）。
Prothrombin fragment F 1.2, an indicator of thrombin generation, was associated with large plaques in stroke patients (p = 0.02), but not in control subjects.
凝血酶原片段1+2（F1+2，凝血酶生成的标识物）与卒中患者的大斑块显著相关（P＝0.02），而对照者无关。
Over a mean follow-up of 55.1 ± 37.2 months, stroke patients with large plaques and F 1.2 over the median value had a significantly higher risk of recurrent stroke and death than those with large plaques but lower F 1.2 levels (230 events per 1,000 person-years vs. 85 events per 1,000 person-years; p = 0.05).
平均随访55.1± 37.2个月后发现，拥有大斑块和F1+2在平均水平以上的患者较仅存在大斑块的卒中患者再发卒中和死亡危险性显著性增加（230事件/1000人年 vs 85事件/1000人年，P=0.05）。
Conclusions: In patients presenting with acute ischemic stroke, large aortic plaques are associated with blood hypercoagulability, suggesting a role for coagulation activation in the stroke mechanism.
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作者:admin@医学,生命科学 2011-02-16 05:14
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