虚弱对AF和HFrEF进行导管切除的患者的影响:全国人口研究
Justin D Mark1, Rosario A Colombo2, Carlos E Alfonso2
1Department of Internal Medicine, University of Miami Miller School of Medicine, Holy Cross Health, Fort Lauderdale, Florida, USA.
JACC. Advances
|November 27, 2024
概括
虚弱性显著增加了老年心力衰竭患者的风险,减少了喷射率和心房动,经历了导管切除,导致死亡率和不良事件的增加.
科学领域:
- 老年医学 老年医学
- 心脏病学 心脏病学
- 临床研究 临床研究
背景情况:
- 虚弱是一种常见的老年综合征,经常与心血管疾病 (如心房动 (AF) 和心力衰竭与减少喷射率 (HFrEF)) 一起存在.
- 导管切除 (CA) 对AF有效,但对接受CA的HFrEF患者结局的脆弱性影响尚不清楚.
研究的目的:
- 为了确定患有HFrEF和AF接受CA的患者的虚弱的患病率.
- 评估心血管疾病对心血管死亡率和出院倾向的影响.
主要方法:
- 利用全国住院患者样本 (2016-2019) 来识别患有AF和HFrEF的患者.
- 使用约翰霍普金斯调整的临床小组来定义脆弱性,包括营养不良,痴呆和跌倒等指标.
- 采用多变量回归分析来比较脆弱和非脆弱患者之间的结果.
主要成果:
- 在113,115名患者中,10.4%被归类为虚弱;虚弱的患者年龄较大,在住院死亡率,主要心血管不良事件和非家庭出院的几率显著增加.
- 与非脆弱患者相比,脆弱患者的住院时间较长.
- 虚弱与所有原因的医院死亡率增加2.64倍,主要心血管不良事件的几率增加2.00倍.
结论:
- 虚弱性与接受AFCA的HFrEF患者的恶化结果有关.
- 将脆弱性评估纳入临床实践可以改善CA患者选择的预后和风险分层.
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