The stroke was caused by the sudden rupture of the blood vessels in the brain or the brain ischemia and hypoxia caused by blood vessel blockage. Stroke includes ischemic stroke and hemorrhagic stroke. According to the data published by the “China Cardiovascular and Cerebral Vascular Popularity Collaboration Research Group”, ischemia in Chinese stroke patients accounted for 62.4 %, cerebral hemorrhage accounted for 27.5 %, and subtinal hemorrhage accounted for 1.8 %.
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As far as we know, there are common risk factors in the brain bleeding and arterial ischemic diseases (such as stroke and myocardial infarction), but the connection between these two cases is still unclear.
In order to evaluate whether in -brain hemorrhage is related to the increased risk of ischemia and myocardial infarction, recently, an analysis published in a research on the American crowd in the Jama Neurology magazine found that compared with ordinary people, the survivors of bleeding in the brain bleeding occurred The risk of ischemic stroke is three times that of ordinary people, and the risk of myocardial infarction (MI) is 2 times.
Dr. Santosh Murthy and his colleagues from the Will Cornell Medical College of New York City analyzed the level data of vertical participants of the four crowd -based queue -based queues in the United States. ) Relations and ethnic differences of geography and ethnic differences in North Manhattan Research (NOMAS).
Nearly 55,131 bleeding participants were admitted to the hospital from 1987 to 2007, and the last patient followed up to December 31, 2018. The main result is arterial ischemia, which is defined as a synthesis of ischemic stroke or myocardial infarction. It is concentrated in each study. The second result is ischemic stroke and myocardial infarction.
Among the 55,131 participants, 4,7866 (27,639 women [57.7%]; average [SD] age, 62.2 [10.2]) meet the analysis conditions. During the mid-level follow-up (7.7-19.5 years) of the 12.7 years, 318 internal bleeding and 7648 epipperns occurred. The incidence of arterial ischemia after cerebral hemorrhage is 3.6/100 years, and those who have no internal bleeding from the brain start from 1.1.
In the adjusted model, cerebral hemorrhage and subsequent arterial ischemia (HR 2.3, 95% CI 1.7-3.1), ischemic stroke (HR 3.1, 95% CI 2.1-4.5), and MI (HR 1.9, 95, 95 %CI 1.2-2.9) The increase in risk increases, an increase of 130%, 210%, and 90%risks, respectively.
In sensitive analysis, when updating the variables in a time change, cerebral hemorrhage is related to arterial ischemia (HR, 2.2; 95% CI, 1.6-3.0); 2.3; 95% CI, 1.3-4.2) and when participants including epidemic brain bleeding, ischemic stroke or myocardial infarction (HR, 2.2; 95% CI, 1.6-2.9.9) have confirmed in-brain bleeding and Related between arterial ischemia.
Murthy and collaborators pointed out that nearly 2.9 million patients around the world experienced intra -brain bleeding every year, and many of them survived and recovered in the initial acute hospitalization. But the ischemia after rehabilitation deserves attention.
This study found that cerebral hemorrhage is related to increased risk of ischemic stroke and myocardial infarction. It shows that cerebral hemorrhage may be a new risk symbol of arterial ischemia.
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Murthy SB， Zhang C， Diaz I， et al. Association Between Intracerebral Hemorrhage and Subsequent Arterial Ischemic Events in Participants From 4 Population-Based Cohort Studies. JAMA Neurol. doi：10.1001/jamaneurol.2021.0925