Ruigómez Ana, Johansson Saga, Wallander Mari-Ann, García Rodríguez Luis Alberto
Centro Español de Investigación Farmacoepidemiológica, Spain.
BMC Cardiovasc Disord. 2002;2:5. doi: 10.1186/1471-2261-2-5. Epub 2002 Feb 26.
To estimate the mortality rate of patients newly diagnosed with chronic atrial fibrillation (AF) and compare it with the one in the general population. To evaluate the role of co-morbidity and other factors on the risk of dying among AF patients.
We used the General Practice Research Database in the UK to perform a retrospective cohort study. We followed a cohort of chronic AF patients (N = 1,035) and an age and sex matched cohort of 5,000 subjects sampled from the general population. We used all deceased AF patients as cases (n = 234) and the remaining AF patients as controls to perform a nested case-control analysis. We estimated mortality risk associated with AF using Cox regression. We computed mortality relative risks using logistic regression among AF patients.
During a mean follow-up of two years, 393 patients died in the general population cohort and 234 in the AF cohort. Adjusted relative risk of death in the cohort of AF was 2.5 (95%CI 2.1 - 3.0) compared to the general population. Among AF patients, mortality risk increased remarkably with advancing age. Smokers carried a relative risk of dying close to threefold. Ischaemic heart disease was the strongest clinical predictor of mortality with a RR of 3.0 (95% CI; 2.1-4.1). Current use of calcium channel blockers, warfarin and aspirin was associated with a decreased risk of mortality.
Chronic AF is an important determinant of increased mortality. Major risk factors for mortality in the AF cohort were age, smoking and cardiovascular co-morbidity, in particular ischaemic heart disease.
评估新诊断为慢性心房颤动（AF）患者的死亡率，并与普通人群的死亡率进行比较。评估合并症及其他因素在AF患者死亡风险中的作用。
我们使用英国全科医学研究数据库进行一项回顾性队列研究。我们追踪了一组慢性AF患者（N = 1035）以及从普通人群中抽取的5000名年龄和性别匹配的受试者组成的队列。我们将所有已故的AF患者作为病例（n = 234），其余AF患者作为对照进行巢式病例对照分析。我们使用Cox回归估计与AF相关的死亡风险。我们在AF患者中使用逻辑回归计算死亡相对风险。
在平均两年的随访期间，普通人群队列中有393名患者死亡，AF队列中有234名患者死亡。与普通人群相比，AF队列中调整后的死亡相对风险为2.5（95%CI 2.1 - 3.0）。在AF患者中，死亡风险随年龄增长显著增加。吸烟者的死亡相对风险接近三倍。缺血性心脏病是最强的死亡临床预测因素，RR为3.0（95%CI；2.1 - 4.1）。当前使用钙通道阻滞剂、华法林和阿司匹林与死亡风险降低相关。
慢性AF是死亡率增加的重要决定因素。AF队列中死亡的主要风险因素是年龄、吸烟和心血管合并症，尤其是缺血性心脏病。
