在米特拉手术中术后心房动不是良性的
Whitney Fu1, China Green1, Catherine Wagner1
1Department of Cardiac Surgery, University of Michigan, Ann Arbor, Mich.
The Journal of thoracic and cardiovascular surgery
|September 14, 2023
概括
心脏手术后的术后心房动 (POAF) 是常见的,并且与更糟糕的结果有关. 这项研究表明POAF增加神经事件,永久性心房动和长期死亡率,挑战其良性感知.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 电力生理学 电力生理学
背景情况:
- 手术后心房动 (POAF) 是心脏手术后的常见并发症.
- 目前的指导方针缺乏管理POAF的具体建议,包括抗凝血值和监测协议.
- 人们通常认为POAF是短暂的,在临床上没有意义,尽管有不良结果的新证据.
研究的目的:
- 为了调查在接受隔离性 mitra 门手术的患者中POAF的发生率.
- 确定POAF与随后的神经事件,永久性心房动和长期死亡率之间的关联.
- 确定与POAF发展相关的风险因素.
主要方法:
- 追溯性队列研究涉及922名成年患者,他们在2011年至2022年期间接受了隔离的 mitra 门手术.
- 在手术前有心律失常史的患者被排除在外.
- 用多变量后勤回归和卡普兰-梅尔分析与Cox比例风险模型来分析风险因素和长期存活率.
主要成果:
- 在POAF的发病率为39%.
- 对POAF的独立风险因素包括年龄的增加和糖尿病.
- POAF显著增加了患永久性心房的风险 (OR,3.2),随后的神经事件 (OR,3.8),并与更糟糕的调整后的长期死亡率相关 (HR,1.8).
结论:
- 隔离性心肌门手术后的POAF不是良性的,并且与显著的不良结果有关.
- POAF是永久性心房动,神经事件和长期死亡率增加的预测因素.
- 这些发现强调需要对经历POAF的患者进行修订的管理策略和监测.
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