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Is functional disability a risk equivalent to the comorbidity of multi-vascular risk factors for cardiovascular events and all-cause death? A 5-year follow-up study

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机构: [a]Evidence-based Medical Center, Xuanwu Hospital, Capital Medical University, Beijing, China [b]Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China [c]Department of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, China
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关键词: cardiovascular event cohort study Functional disability risk factor survival

摘要:
Background/objectives: Functional disability (FD) is common after stroke and associated with the occurrence of future adverse events; however, whether FD is as strong a risk factor as comorbid vascular risk factors for cardiovascular events and death is unclear. Methods: Consecutive patients 3–6 months after index ischemic stroke were assessed at baseline and followed up for documented new cardiovascular events (recurrent stroke, acute myocardial infarction, and sudden death) and death within 5 years. Comorbidity of vascular risk factors was stratified as low or intermediate-to-high risk according to the Stroke Prognostic Instrument II. Four mutually exclusive cohorts were identified (1) intermediate-to-high risk only, n = 505, (2) FD only, n = 78, (3) both intermediate-to-high risk and FD, n = 264, and (4) low risk and no FD, n = 240. Results: The incidence of cardiovascular events was lowest in patients free of FD with low risk, followed by patients with FD alone, intermediate-to-high risk alone, and both. Compared with intermediate-to-high risk only, patients free of FD with low risk had a significantly lower adjusted hazard ratio (HR) (HR: 0.56, 95% confidence interval [CI]: 0.33–0.94), patients with FD only had a similar HR (HR: 0.47, 95% CI: 0.19 –1.18), and patients with both FD and intermediate-to-high risk had a significantly higher HR (HR: 2.13, 95% CI: 1.53–2.98) of cardiovascular events. A similar trend but a larger HR was noted for all-cause death. Conclusion: FD 3–6 months after ischemic stroke is a risk equivalent to comorbidity of conventional vascular risk factors for the incidence of cardiovascular events and mortality of all-cause death. © 2020, © 2020 Taylor & Francis Group, LLC.

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基金编号: 2014-1-1031

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出版当年[2019]版:
大类 | 4 区 医学
小类 | 3 区 康复医学
最新[2023]版:
大类 | 4 区 医学
小类 | 4 区 康复医学
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出版当年[2018]版:
Q2 REHABILITATION
最新[2023]版:
Q1 REHABILITATION

影响因子: 最新[2023版] 最新五年平均 出版当年[2018版] 出版当年五年平均 出版前一年[2017版] 出版后一年[2019版]

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第一作者机构: [a]Evidence-based Medical Center, Xuanwu Hospital, Capital Medical University, Beijing, China
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通讯机构: [*1]Evidence-based Medical Center, Xuanwu Hospital, Capital Medical University, #45 Changchun Street, Beijing 100053, China
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