75岁以上老年患者的肺静脉隔离:倾向性得分匹配分析,重点关注心房动类型之间的差异
Andreas A Boehmer1, Moritz Rothe1, Christoph Keim1
1Department of Cardiology, St Josefs-Hospital, Wiesbaden, Germany.
The Canadian journal of cardiology
|February 3, 2024
概括
与年轻人相比,对于心房动 (AF) 的冷气球移除 (CBA) 显示老年患者 (≥75岁) 的复发率更高. 患有持续性AF的老年患者经历了CBA后AF复发的最高率.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 老年医学 老年医学
背景情况:
- 年龄是心房动 (AF) 的重要危险因素.
- 患有AF的老年患者在节律控制疗法后经常经历更高的复发率.
- 现有的有关老年人导管切除疗效和安全性的数据有限.
研究的目的:
- 调查年龄对冷气球移除 (CBA) 对AF的疗效和安全性的影响.
- 为了比较接受CBA的年轻 (<75岁) 和老年 (≥75岁) 患者之间的结果.
- 分析AF表型 (发性与持久性) 对不同年龄组的切除结果的影响.
主要方法:
- 前性,单中心的观察性研究.
- 使用倾向分数匹配 (PSM) 来创建年轻和老年患者的可比组.
- 主要疗效终点:在90天的空白期后,心房节律失常的复发.
- 安全终点:死亡,中风或与手术相关的并发症.
主要成果:
- 总共有953名患者首次接受了AF的CBA.
- 在1年的随访中,老年患者的复发率明显高 (33.2%) 与年轻患者 (22.4%) 相比 (HR,0.65;P=0.01).
- 在老年患有持续性AF的患者 (38.8%) 和年轻患者 (25.9%) (HR,0.62;P=0.038) 中观察到更高的复发率.
- 在年龄组之间没有发现安全终点 (死亡,中风,并发症) 的显著差异.
结论:
- 冰冷气球除与老年患者 (≥75岁) 的AF复发率增加有关.
- 患有持续性AF的老年患者代表了CBA后复发风险最高的亚组.
- 在年轻和老年患者群体中,CBA显示了可比的安全性.
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