多种疾病增加了永久性心房动心血管结果的风险:来自RACE II研究的数据
Colinda van Deutekom1, Marieke J H Velt1, Isabelle C van Gelder1
1Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
概括
在最近出现永久性心房动 (AF) 的患者中,多种病变是常见的. 更多的并发症显著增加了心血管不良结果的风险,包括死亡率和中风.
科学领域:
- 心脏病学 心脏病学
- 内部医学 内部医学
- 老年病的医生 老年病的医生
背景情况:
- 在心房动 (AF) 患者中,多种疾病很普遍,但其对永久性AF的影响需要进一步调查.
- 了解并发症负担对于管理永久性AF中的心血管风险至关重要.
研究的目的:
- 确定近期出现永久性AF的患者多病症的流行率.
- 评估该人口中并发症数量与心血管结果之间的关联.
主要方法:
- 对RACE II随机对照试验数据的分析,该试验涉及614名近期出现永久性AF的患者.
- 评估了并发症,并根据并发症数量 (0-1,2-3,≥4) 将患者分组.
- 考克斯回归和卡普兰-梅尔分析评估了伴随性疾病负担和3年内心血管事件的综合结果之间的联系.
主要成果:
- 三分之二的患者呈现多病症 (≥2种并发症).
- 更多的并发症与主要复合结局,心血管死亡率,心力衰竭住院,中风/全身栓塞率的增加相关.
- 与0-1并发症患者相比,患有≥4种并发症的患者面临的初级综合结局风险高出2.27倍 (HR 2.27,95% CI [1.21-4.23]).
结论:
- 在最近出现的永久性AF中,多种病态性非常普遍.
- 增加并发症负担是永久性AF患者心血管不良结果的重要预测因素.
- 风险分层和管理策略应考虑永久性AF患者多病症的程度.
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