心脏手术后心房动的多中心风险指数
Joseph P Mathew1, Manuel L Fontes, Iulia C Tudor
1Multicenter Study of Perioperative Ischemia Research Group and Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA. mathe014@mc.duke.edu
JAMA
|April 15, 2004
概括
心房动 (AF) 是冠状动脉旁路移植 (CABG) 手术后的常见并发症. 这项研究开发了一个风险指数,以识别患有AF风险的患者,发现某些药物,如β抑制剂和ACE抑制剂,可能会提供保护.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 临床研究 临床研究
背景情况:
- 心房动 (AF) 是冠状动脉旁路移植 (CABG) 手术后的常见并发症.
- 识别患有CABG后AF风险的患者对于预防策略至关重要.
研究的目的:
- 评估CABG后AF的特征和后果.
- 创建和验证CABG后AF的预测风险指数.
主要方法:
- 一项前性观察性研究涉及4657名在17个国家的70个中心接受CABG的患者.
- 一个导出队列 (3093名患者) 被用来开发一个风险模型,然后在一个单独的队列 (1564名患者) 中验证.
主要成果:
- 32.3%的患者在CABG后出现了新发的AF.
- 风险因素包括晚年,先前的AF,COPD,门手术和药物停用 (β-阻断剂,ACE抑制剂).
- 保护因素包括手术后的β-抑制剂,ACE抑制剂,NSAID和补充剂. 风险指数显示出良好的区分能力 (AUC=0.77).
结论:
- 经过验证的模型有效地预测CABG后的AF发生.
- 贝塔抑制剂,ACE抑制剂和NSAIDs可能会降低AF风险.
- 后CABG AF与严重的并发症有关,包括增加资源使用和不良事件.
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