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Progreso a largo plazo y resultados con el envejecimiento en pacientes con fibrilación auricular solitaria: un
Arshad Jahangir1, Victor Lee, Paul A Friedman
1Division of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
Circulation
|June 6, 2007
Resumen
La progresión de la fibrilación auricular solitaria (FA) a FA permanente es común, pero la supervivencia a largo plazo es similar a la de la población general. Las comorbilidades como la hipertensión aumentan el riesgo de accidente cerebrovascular en pacientes con AF.
Área de la Ciencia:
- Cardiología Cardiología.
- Epidemiología La epidemiología.
- La medicina clínica es la medicina clínica.
Sus antecedentes:
- La historia natural a largo plazo de la fibrilación auricular solitaria (FA) sigue siendo en gran medida desconocida.
- Comprender la progresión y las complicaciones a largo plazo es crucial para el manejo del paciente.
Objetivo del estudio:
- Determinar la velocidad y los predictores de la progresión de la FA paroxística a la permanente durante 30 años.
- Para evaluar el riesgo a largo plazo de insuficiencia cardíaca, tromboembolismo y muerte en pacientes con FA aislados en comparación con una población de control.
Principales métodos:
- Se realizó un seguimiento a largo plazo de una cohorte de 76 pacientes con FA solitaria (paroxística, persistente o permanente) diagnosticada entre 1950 y 1980 en el condado de Olmsted, Minnesota.
- La supervivencia, la progresión a FA permanente y la incidencia de insuficiencia cardíaca y eventos tromboembólicos se compararon con controles de edad y sexo coincidentes.
Principales resultados:
- A lo largo de 30 años, 22 de 71 pacientes con FA paroxística o persistente solitaria progresaron a una FA permanente.
- La supervivencia global fue similar a la de la población general, pero la supervivencia sin insuficiencia cardíaca fue ligeramente peor.
- El riesgo tromboembólico, incluido el accidente cerebrovascular o el ataque isquémico transitorio, aumentó después de 25 años, particularmente en pacientes que desarrollaron factores de riesgo.
Conclusiones:
- Las comorbilidades influyen significativamente en la progresión y las complicaciones de la fibrilación auricular.
- El aumento de la edad y el desarrollo de la hipertensión son factores clave que elevan el riesgo tromboembólico en pacientes con FA solitarios.
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