心房动和心肌梗塞后的死亡:一个社区研究
Patricia Jabre1, Xavier Jouven, Frédéric Adnet
1Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA.
Circulation
|May 4, 2011
概括
心房动 (AF) 在心肌梗塞 (MI) 后很常见,并显著增加死亡风险. 在心脏病发作后30天以上发生AF的风险最高.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 心房动 (AF) 经常与心肌梗塞 (MI) 并存,但其对预后的影响仍在争论中.
- 之前关于AF和MI死亡率的研究往往侧重于早期住院治疗,缺乏时间细节.
- 需要基于社区的数据来了解心脏病发作后的AF时间的实际影响.
研究的目的:
- 评估发生性心脏病的发生和趋势在发生性心脏病的患者中.
- 量化AF对心脏病发作后所有原因和心血管死亡率的影响.
- 为了确定AF相对于MI的时间如何影响死亡风险.
主要方法:
- 基于社区的队列研究,对3220名患者进行了首次心脏病发作 (1983-2007) 的住院治疗.
- 通过诊断码和心电图确定AF;结果是所有原因和心血管死亡.
- 平均随访时间为6.6年,并分析了AF时间 (前,在2天内,3-30天,MI后>30天).
主要成果:
- 在304名患者中,AF发生在心脏病发作之前,在729名患者中发生在心脏病发作后.
- 在5年内,心脏病发作后AF的累积发病率为19%,并没有随着时间的推移而变化.
- AF与死亡风险增加3.77倍相关,AF发展>30天后MI (HR2.58) 的风险最高.
结论:
- 心房动是社区中心肌梗塞的常见并发症.
- AF显著增加了心脏病发作后的死亡风险.
- 当心肌梗塞发生后超过30天时,心肌梗塞的预后影响最大.
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