Suzuki Shinya, Yamashita Takeshi, Ohtsuka Takayuki, Sagara Koichi, Uejima Tokuhisa, Oikawa Yuji, Yajima Junji, Koike Akira, Nagashima Kazuyuki, Kirigaya Hajime, Ogasawara Ken, Sawada Hitoshi, Aizawa Tadanori
The Cardiovascular Institute, 7-3-10 Roppongi, Minato-ku, Tokyo 106-0032, Japan.
Circ J. 2008 Jun;72(6):914-20. doi: 10.1253/circj.72.914.
Prognosis of Japanese patients with atrial fibrillation (AF) should be determined in a prospective cohort study.
A prospective cohort of The Shinken Database 2004 comprised details on all the new patients who visited The Cardiovascular Institute Hospital in 2004 (n=2,412), which included 286 AF patients (11.8%, 205 males, 64.1+/-12.3 years, 165 paroxysmal). In this Japanese cohort of AF patients, the prevalence of congestive heart failure (CHF) was low compared with that in Westerners. Total mortality and cardiovascular morbidity of these patients were also quite low, 1.7% and 11.2% at 1 year, respectively. However, patients with CHF exhibited higher mortality (7.3%), and hospitalization for CHF increased the rate to 22.6%. There was no significant difference in mortality between paroxysmal and persistent AF. Multiple Cox-hazard regression analysis identified hospitalization at initial visit and lack of anticoagulation as independent predictors for mortality, and existence of CHF as the only independent predictor for cardiovascular morbidity. CONCLUSIONS The present study identified the mortality (1.7%) and morbidity (11.2%) of Japanese AF patients during 1 year after initial visit. Hospitalization for CHF and lack of anticoagulation were independent predictors for mortality, suggesting important roles of co-morbidities of Japanese AF patients.
日本房颤（AF）患者的预后应在前瞻性队列研究中确定。
“新研数据库2004”的前瞻性队列包含了2004年就诊于心血管病研究所医院的所有新患者的详细信息（n = 2412），其中包括286例房颤患者（11.8%，男性205例，年龄64.1±12.3岁，阵发性房颤165例）。在这个日本房颤患者队列中，与西方人相比，充血性心力衰竭（CHF）的患病率较低。这些患者的总死亡率和心血管疾病发病率也相当低，1年时分别为1.7%和11.2%。然而，患有CHF的患者死亡率较高（7.3%），因CHF住院使这一比率升至22.6%。阵发性房颤和持续性房颤患者的死亡率无显著差异。多因素Cox风险回归分析确定初次就诊时住院和未进行抗凝治疗是死亡率的独立预测因素，而CHF的存在是心血管疾病发病率的唯一独立预测因素。结论：本研究确定了日本房颤患者初次就诊后1年内的死亡率（1.7%）和发病率（11.2%）。因CHF住院和未进行抗凝治疗是死亡率的独立预测因素，提示日本房颤患者合并症的重要作用。
