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Titolo:
Predictors of cerebrovascular events and death among patients with valvular heart disease - A population-based study
Autore:
Petty, GW; Khandheria, BK; Whisnant, JP; Sicks, JD; OFallon, WM; Wiebers, DO;
Indirizzi:
Mayo Clin & Mayo Fdn, Div Cerebrovasc Dis, Rochester, MN 55905 USA Mayo Clin & Mayo Fdn Rochester MN USA 55905 Dis, Rochester, MN 55905 USA Mayo Clin & Mayo Fdn, Div Cardiovasc Dis & Internal Med, Rochester, MN 55905 USA Mayo Clin & Mayo Fdn Rochester MN USA 55905 Med, Rochester, MN 55905 USA Mayo Clin & Mayo Fdn, Dept Hlth Sci Res, Rochester, MN 55905 USA Mayo Clin& Mayo Fdn Rochester MN USA 55905 Res, Rochester, MN 55905 USA
Titolo Testata:
STROKE
fascicolo: 11, volume: 31, anno: 2000,
pagine: 2628 - 2635
SICI:
0039-2499(200011)31:11<2628:POCEAD>2.0.ZU;2-0
Fonte:
ISI
Lingua:
ENG
Soggetto:
MITRAL-VALVE DISEASE; PULSED DOPPLER ECHOCARDIOGRAPHY; AORTIC-VALVE; NATURAL-HISTORY; SYSTEMIC EMBOLISM; RHEUMATIC-FEVER; INCIDENCE RATES; FOLLOW-UP; STENOSIS; STROKE;
Keywords:
atrial fibrillation; cerebral embolism and thrombosis echocardiography; heart valve diseases; stroke;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
53
Recensione:
Indirizzi per estratti:
Indirizzo: Petty, GW Mayo Clin & Mayo Fdn, Div Cerebrovasc Dis, 200 1st St SW, Rochester, MN 55905 USA Mayo Clin & Mayo Fdn 200 1st St SW Rochester MN USA 5590505 USA
Citazione:
G.W. Petty et al., "Predictors of cerebrovascular events and death among patients with valvular heart disease - A population-based study", STROKE, 31(11), 2000, pp. 2628-2635

Abstract

Background and Purpose-There is little population-based information on cerebrovascular events and survival among valvular heart disease patients. We used the Kaplan-Meier product-limit method and the Cox proportional hazardsmodel to determine rates and predictors of cerebrovascular events and death among valve disease patients. Methods-This population-based historical cohort study in Olmsted County, Minnesota, reviewed residents with a first echocardiographic diagnosis of mitral stenosis (n = 19), mitral regurgitation (n = 528), aortic stenosis (n = 140), and aortic regurgitation (n = 106) between 1985 and 1992. Results-During 2694 person-years of follow-up, 98 patients developed cerebrovascular events and 356 died. Compared with expected numbers, these observations are significantly elevated, with standardized morbidity ratio of 3.2 (95% CI, 2.6 to 3.8) and 2.5 (95% CI, 2.2 to 2.7), respectively. Independent predictors of cerebrovascular events were age, atrial fibrillation, andsevere aortic stenosis. The risk ratio of severe aortic stenosis was 3.5 (95% CI, 1.4 to 8.6), with atrial fibrillation conferring greater risk at younger age. Predictors of death were age, sex, cerebrovascular events, ischemic heart disease, and congestive heart failure, the greatest risk being among those with both congestive heart failure and cerebrovascular events (risk ratio = 8.8; 95% CI, 5.8 to 13.4). Valve disease type and severity were not independent determinants of death. Conclusions-The risk of cerebrovascular events and death among patients with valve disease remains high. Age, atrial fibrillation, and severe aortic stenosis are independent predictors of cerebrovascular events, and age, sex, cerebrovascular events, congestive heart failure, and ischemic heart disease are independent predictors of death in these patients.

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Documento generato il 04/04/20 alle ore 21:21:32