通过体质指数和心力衰竭状态分层的心房患者的结果
Jean Jacques Noubiap1, Lisa A Kaltenbach2, Karen Chiswell2
1Centre for Heart Rhythm Disorders, Adelaide University and Royal Adelaide Hospital, Adelaide, Australia; Division of Cardiology, Department of Medicine, University of California-San Francisco, San Francisco, California, USA.
JACC. Advances
|January 20, 2026
概括
肥胖悖论,心力衰竭 (HF) 和心房动 (AF) 患者的生存益处,在非肥胖患者中显示出更高的BMI,但在AF的肥胖患者中没有.
科学领域:
- 心脏病学 心脏病学
- 内部医学 内部医学
- 公共卫生 公共卫生
背景情况:
- 这是一个很棒的节目,这是一个很棒的节目.
- 肥胖的悖论 肥胖的悖论
- (在超重或肥胖个体中观察到的生存益处) 在心力衰竭 (HF) 和心房动 (AF) 患者中不一致报告.
研究的目的:
- 研究身体质量指数 (BMI) 和心力衰竭 (HF) 状态之间的相互作用对心房动 (AF) 患者的结果的影响.
主要方法:
- 利用了与医疗保险索赔相关的Get With The Guidelines - 心房的注册表 (2013-2021) 的数据.
- 员工调整了考克斯的比例危险模型来分析BMI和结果之间的关联,按HF状态分层 (没有HF,HFpEF/HFmrEF,HFrEF).
- 评估的一年结果包括死亡率,心血管再住院,血栓栓塞和心肌梗塞.
主要成果:
- 在21,850名患者中,增加的BMI与所有HF状态的非肥胖个体的较低死亡率有关.
- 这种生存益处在肥胖和AF患者中没有观察到 (相互作用P = 0.013).
- 心血管再住院,血栓塞栓和心肌梗塞的风险在整个心血管频谱的肥胖和非肥胖患者之间没有显著差异.
结论:
- 较高的BMI与不肥胖的AF患者的生存率改善有关,无论其HF状态如何.
- 这种生存益处不适用于被归类为肥胖的AF患者.
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