患有心房动的老年患者心力衰竭:发病率和危险因素
María Melendo-Viu1, Sergio Raposeiras-Roubín2, Emad Abu-Assi2
1Departamento de Cardiología, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, Spain; Instituto de Investigación Sanitaria Galicia Sur, Vigo, Pontevedra, Spain; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain.
Revista espanola de cardiologia (English ed.)
|June 28, 2023
概括
心脏衰竭 (HF) 在33.3%的老年心房动 (AF) 患者中发生. 识别11个风险因素可以帮助制定AF中HF的初级预防策略.
科学领域:
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
- 公共卫生 公共卫生
背景情况:
- 心房动 (AF) 是心力衰竭 (HF) 的已知危险因素.
- 在AF患者中,特别是老年人中,导致HF的因素需要进一步调查.
- 关于新发性HF在没有HF病史的老年AF患者中发生率,预测因素和预后的研究有限.
研究的目的:
- 确定80岁以上心房动 (AF) 且没有先前心房动的患者新发性心力衰竭 (HF) 的发生率.
- 确定与该人群中发生HF发病相关的临床风险因素.
- 评估发生性HF对死亡风险的预后影响.
主要方法:
- 追溯队列研究包括5794名80岁以上的AF患者和没有HF病史的80岁以上患者,在2014-2018年间确定.
- 随访时间为3.7年,以确定发生的HF和死亡率.
- 多变量分析以确定HF的独立预测因子并评估死亡风险.
主要成果:
- 事件HF在33%的队列中发生,主要保留左心室喷射分数.
- 确定了11种发生性HF的临床风险因素:膜心脏病,减少喷射率,慢性肺炎,左心房扩大,功能障碍,营养不良,贫血,永久性AF,糖尿病,年龄增长和高BMI.
- 发生HF与死亡风险增加近两倍有关 (HR, 1.67).
结论:
- 心力衰竭是老年患有AF的患者经常出现的并发症,显著增加死亡率.
- 确定了11种不同的临床风险因素,为这种脆弱人群提供了HF初级预防的目标.
- 这些发现强调了在老年AF患者中主动风险因素管理的重要性,以预防HF发展和改善结果.
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