SwePub
Sök i LIBRIS databas

  Utökad sökning

onr:"swepub:oai:DiVA.org:uu-23971"
 

Sökning: onr:"swepub:oai:DiVA.org:uu-23971" > Predictors of strok...

Predictors of stroke within 30 days in patients with non-ST-segment elevation acute coronary syndromes

Westerhout, Cynthia M. (författare)
Hernández, Adrián V. (författare)
Steyerberg, Ewout W. (författare)
visa fler...
Bueno, Héctor (författare)
White, Harvey (författare)
Théroux, Pierre (författare)
Moliterno, David J. (författare)
Armstrong, Paul W. (författare)
Califf, Robert M. (författare)
Wallentin, Lars, 1943- (författare)
Uppsala universitet,Institutionen för medicinska vetenskaper,Uppsala kliniska forskningscentrum (UCR)
Simoons, Maarten L. (författare)
Boersma, Eric (författare)
visa färre...
 (creator_code:org_t)
2006
2006
Engelska.
Ingår i: European Heart Journal. - 0195-668X .- 1522-9645. ; 27:24, s. 2956-2961
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • AIMS: Stroke is an uncommon but serious complication after non-ST-segment elevation acute coronary syndrome (NSTE-ACS). We aimed to identify predictors of stroke within 30 days in patients who suffered NSTE-ACS. METHODS AND RESULTS: We pooled data from six trials (n=31 402) that randomized NSTE-ACS patients either to platelet glycoprotein (GP) IIb/IIIa receptor blockers or to placebo/control therapy. Potential predictors of stroke included treatment, demographic, and clinical characteristics. We identified predictors using univariable and multivariable logistic models, and their performance was evaluated with calibration (Hosmer-Lemeshow test) and discrimination (c-statistic). We found 228 (0.7%) all-cause strokes: 155 (0.5%) non-haemorrhagic, 20 (0.06%) haemorrhagic, and 53 without computed tomography (CT) confirmation. Patients with any type of stroke had a 30-day mortality of 25%. Randomization to GP IIb/IIIa receptor blockers was not significantly associated with all-cause stroke [OR (95% CI) 1.08 (0.83-1.41)]. Older age [OR per 10-year increase 1.5 (1.3-1.7)], prior stroke [2.1 (1.4-3.1)], and elevated heart rate [per 10-beat increase 1.1 (1.0-1.2)] were the strongest predictors of 30-day all-cause stroke. Similar predictors were found for non-haemorrhagic and haemorrhagic strokes. Smoking, previous myocardial infarction, diabetes, and hypertension were not independent predictors of all-cause stroke. The multivariable model to predict all-cause stroke was well calibrated, but its discrimination was only moderate [c-statistic 0.69 (0.65-0.72)]. CONCLUSION: Stroke is a rare complication occurring early after NSTE-ACS, but is associated with high mortality. We found no evidence that GP IIb/IIIa receptor blockers increase stroke risks. A few clinical characteristics predicted higher stroke risks. Thus, incident strokes in NSTE-ACS patients remain largely unexplained.

Nyckelord

Mortality
Non-ST-segment elevation acute coronary syndromes
Platelet glycoprotein IIb/IIIa receptor blocker
Prediction
Stroke
MEDICINE
MEDICIN

Publikations- och innehållstyp

ref (ämneskategori)
art (ämneskategori)

Hitta via bibliotek

Till lärosätets databas

Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.

 
pil uppåt Stäng

Kopiera och spara länken för att återkomma till aktuell vy