RESUMEN
BACKGROUND: Atrial fibrillation has been associated with higher morbidity and mortality rates in acute ischemic stroke patients (AIS). However, there is scarce information regarding the clinical outcomes and strokes' characteristics among AIS patients with other type of arrhythmias. OBJECTIVE: Our study aims to analyze the hospital mortality rate, stroke characteristics, and clinical and demographical data of patients with any post-stroke arrhythmia. METHODS: Retrospective cohort study of AIS patients with 24h-Holter monitoring during hospital admission recruited between 2015-2020, outcomes were measured using the modified Rankin scale. RESULTS: 597 patients (61.13±13.61 years; 352 men) were included. Arrhythmias were diagnosed in 33 (5.5%), with atrial fibrillation as the most common finding (82%). Age was related to a higher rate of arrhythmia (P = 0.014). A larger prevalence of cardioembolic strokes (69.7% vs 16.6%, P < 0.05) and AIS in the middle cerebral artery's vascular territory (78.8% vs 58.7%, P < 0.05) were found amongst patients with an arrhythmia. No significant association was found between NIHSS at admission with neither incidence of arrhythmia nor mortality. Within the arrhythmia group, three in-hospital deaths were reported: one AF, one ventricular arrhythmia and one second-degree atrioventricular block. In a logistic regression analysis, patients with any kind of arrhythmia had a higher mortality rate (9.1% vs 1.2%, P = 0.011; OR 6.766, 95% CI 1.552 - 29.500). CONCLUSION: Arrhythmia detection after an AIS was associated with increased in-hospital mortality. Risk factors related to arrhythmia detection were a higher mean age, cardioembolic strokes and AIS affecting the middle cerebral artery.
Asunto(s)
Arritmias Cardíacas , Mortalidad Hospitalaria , Accidente Cerebrovascular Isquémico , Anciano , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/epidemiología , Fibrilación Atrial/diagnóstico , Fibrilación Atrial/epidemiología , Femenino , Mortalidad Hospitalaria/tendencias , Humanos , Accidente Cerebrovascular Isquémico/mortalidad , Accidente Cerebrovascular Isquémico/terapia , Masculino , México/epidemiología , Persona de Mediana Edad , Estudios Retrospectivos , Factores de RiesgoRESUMEN
Toxins have been shown to be an important virulence component for most pathovars of Pseudomonas syringae. Here we have examined the role of phaseolotoxin in the virulence mechanism of P. syringae pv. phaseolicola by producing transgenic tobacco plants that express a pathogen-derived toxin-resistant target enzyme. Such plants are insensitive to the toxin and less prone to infection by the pathogen.