每天最大心房动持续时间的变化,缺血性中风和死亡率之间的关联
Graham Peigh1, Jodi Koehler2, Shubha Majumder2
1Division of Cardiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.
随着时间的推移,心房 (AF) 负担的增加与心脏植入式电子设备 (CIED) 患者的中风和死亡风险增加有关,而不是抗凝药. 监测AF持续时间的变化对于风险评估至关重要.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 公共卫生 公共卫生
背景情况:
- 心房动 (AF) 的结果受到AF负担的持续测量的影响.
- 了解AF负担动态对于管理患者风险至关重要.
研究的目的:
- 评估最大每日AF持续时间 (MDAFD) 变化与中风或死亡风险之间的关联.
- 为了在没有接受口服抗凝药的心脏植入式电子设备 (CIED) 患者中调查这些关联.
主要方法:
- 使用了Optum无标识的电子健康记录数据,与Medtronic CareLink心律数据库 (2007-2021) 相连接.
- 包括有CIED患者和记录的医疗保健活动,但不包括服用口服抗凝药的患者.
- 在基线 (植入后30天) 和在审查或事件之前评估MDAFD,为CHA2DS2-VASc组件调整HRs,基线MDAFD和慢性病.
主要成果:
- 分析了26,400名患者;9.6%的人在基线时有AF.
- 在随访期间增加的MDAFD与更高的中风和死亡率相关 (HR:1.80).
- 降低的MDAFD与综合终点 (HR:0.82) 没有显著关联,但子组分析显示了特定基线MDAFD类别的风险降低.
结论:
- 在非服用口服抗凝药的CIED患者中,MDAFD的增加与中风和死亡率的增加有关.
- AF负担及其相关风险是动态的,可以随着时间的推移而变化,强调需要持续监测.
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