在被诊断为心房动后的长期心血管风险:系统审查和元分析
Lan Mu1, Harriet Larvin1, Ramesh Nadarajah2,3
1Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
Heart (British Cardiac Society)
|September 17, 2025
概括
心力衰竭是心房动 (AF) 患者中最常见的心血管并发症. 与中风和其他事件不同,心力衰竭发生率没有下降,需要有针对性的预防策略.
科学领域:
- 心脏病学 心脏病学
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 对于心血管并发症的当代风险估计,心房后 (AF) 诊断对于临床管理至关重要.
- 量化这些风险有助于选择临床试验的结果,并优化医疗服务的提供.
研究的目的:
- 系统地审查和综合发病率 (IRs),风险,和在被诊断为AF的患者心血管不良事件的时间趋势.
主要方法:
- 包括从2015年起发表的纵向队列研究,报告AF患者心血管事件.
- 使用随机效应元分析,将IRs组合在一起.
- 进行了元回归,以评估年龄,CHA2DS2-VASc分数,地理区域,研究期和性别对IR的影响.
主要成果:
- 分析了73项研究 (5,498,857名患者; 24,817,465人年).
- 最常见的事件:心力衰竭 (IR 2.98),缺血性中风 (IR 1.76),心血管死亡 (IR 1.66) 和心肌梗塞 (IR 0.64) 每100人/年.
- 缺血性中风,心血管死亡和心肌梗塞的发生率随着时间的推移而下降,而心力衰竭的发生率仍然持久.
结论:
- 心力衰竭是AF患者最常见和持续的心血管不良结果.
- 尽管在预防中风方面取得了进展,但心力衰竭的发生率需要有针对性的策略和指导方针的强调.
- 需要进一步的研究来预防心力衰竭和了解AF中的性别特异性心血管风险.
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