- 作者：Amit Segev ; Bradley H. Strauss ; Mary Tan ; Christopher E. Buller ; Aurora A. Mendelsohn ; Anatoly Langer ; Shaun G. Goodman ; for the Canadian Acute Coronary Syndrome Registries Investigators
- 刊名：International Journal of Cardiology
- 出版年：2008
- 出版时间：26 September 2008
- 年：2008
- 卷：129
- 期：2
- 页码：233-237
- 全文大小：127 K
ObjectivesTo identify predictors of ischemic stroke in patients with suspected non-ST elevation (NSTE) acute coronary syndrome (ACS) and to evaluate in-hospital and 1-year outcomes.Methods
We analyzed 5842 patients with diagnosed NSTE ACS included in the multi-center Canadian ACS registries. Patients with in-hospital stroke (n = 28, 0.5 % ) were compared to patients without stroke. Risk factors and short- and long-term outcome were evaluated.
Results
Baseline characteristics of patients with and without stroke were similar except for a significantly higher proportion of women, higher rates of in-hospital CABG, and greater use of unfractionated heparin. Crude event rates were significantly higher in patients with stroke: in-hospital death 21.4 % vs. 1.6 % (p < 0.0001), MI 10.7 % vs. 4.0 % (p = 0.10), and death or MI 32.1 % vs. 5.1 % (p < 0.0001). One-year event rates were also higher in patients with stroke: death 32.1 % vs. 7.4 % (p < 0.0001), and death or MI 39.3 % vs. 13.5 % (p < 0.001). In multivariable analysis, independent predictors for stroke were female gender (OR 3.12, 95 % CI 1.36–7.14, p = 0.007), and Killip class ≥ 2 on admission (OR 2.87, 1.18–6.99, p = 0.02). Stroke was an independent predictor of in-hospital death (OR 14.52, 4.57–46.12, p < 0.0001), death or MI (6.0, 2.44–14.75, p < 0.0001), as well as 1-year death (5.50, 1.94–15.60, p = 0.0014), and death or MI (2.89, 1.15–7.27, p = 0.025).
Conclusions
In patients with NSTE ACS, stroke is associated with increased short- and long-term rates of death and MI. Stroke is highly predicted by female gender and Killip class on admission.