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2型糖尿病患者心室颤动患病率增加。

Increased prevalence of ventricular fibrillation in patients with type 2 diabetes mellitus.

作者信息

Movahed Mohammad-Reza, Hashemzadeh Mehrtash, Jamal Mazen

机构信息

Department of Medicine, Section of Cardiology, University of Arizona Sarver Heart Center, 1501 North Campbell Avenue, Tucson, AZ 85724-5037, USA.

出版信息

Heart Vessels. 2007 Jul;22(4):251-3. doi: 10.1007/s00380-006-0962-9. Epub 2007 Jul 20.

Abstract

Diabetes mellitus (DM) is an independent risk for cardiovascular disease. Furthermore, patients with DM have increased risk for ventricular arrhythmia that is thought to be secondary to coronary artery disease (CAD) or congestive heart failure (CHF). We hypothesized that DM may cause ventricular arrhythmias independent of CAD or CHF. Using a large database, we evaluated the occurrence of ventricular fibrillation in patients with DM adjusting for CAD and CHF. We used patient treatment files (PTF), documents of inpatients' admissions containing discharge diagnoses (ICD-9 codes) from all Veterans Health Administration Hospitals. The patients were stratified in two groups: ICD-9 code for DM (293 124) and a control group with ICD-code for hypertension (HTN) but no DM (552 623). ICD-9 codes for ventricular fibrillation were used for this study. We performed uni- and multivariant analysis adjusting for comorbid conditions. Ventricular fibrillation was present in 563 (0.2%) vs 781 (0.1%) in the control group. Using multivariate analysis, DM remained independently associated with ventricular fibrillation (odds ratio: 1.7; confidence interval: 1.5-1.9; P < 0.000). Patients with DM have significantly higher prevalence of ventricular fibrillation independent of CAD or CHF, which in part may explain the higher risk of sudden death in patients with DM.

摘要

糖尿病(DM)是心血管疾病的独立危险因素。此外,糖尿病患者发生室性心律失常的风险增加,这被认为是冠状动脉疾病(CAD)或充血性心力衰竭(CHF)的继发结果。我们假设糖尿病可能独立于CAD或CHF导致室性心律失常。利用一个大型数据库,我们评估了在调整CAD和CHF因素后糖尿病患者中室颤的发生情况。我们使用了患者治疗档案(PTF),即来自所有退伍军人健康管理局医院的包含出院诊断(ICD-9编码)的住院患者入院文件。患者被分为两组:糖尿病的ICD-9编码(293 124)组和有高血压(HTN)ICD编码但无糖尿病的对照组(552 623)。本研究使用室颤的ICD-9编码。我们对合并症进行了单变量和多变量分析。室颤在糖尿病组中的发生率为563例(0.2%),而对照组为781例(0.1%)。通过多变量分析,糖尿病仍然独立与室颤相关(比值比:1.7;置信区间:1.5 - 1.9;P < 0.000)。糖尿病患者室颤的患病率显著高于对照组,且独立于CAD或CHF,这在一定程度上可能解释了糖尿病患者猝死风险较高的原因。

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