Donetskaia O P, Evdokimova M A, Osmolovskaia V S, Reznichenko N E, Krasil'nikova E S, Dankovtseva E N, Selezneva N D, Glezer M G, Tereshchenko S N, Sidorenko B A, Zateĭshchikov D A
Kardiologiia. 2009;49(1):19-24.
For the study of contribution of atrial fibrillation (AF) during acute coronary syndrome (ACS) in long-term prognosis after clinical stabilization we examined 453 patients admitted to Moscow hospitals and followed them for 2.07 +/- 0.48 years. The following events were registered: fatal and nonfatal myocardial infarction (MI), unstable angina (UA), fatal and nonfatal stroke, death of other causes. At ACS onset sinus rhythm was noted in 419 (92.5%), permanent or persistent AF-in 16 (3.5%), attack (paroxysm) of AF - in 18 (4.0%) patients. Mean length of life before end point was 884.9 +/- 23.4, 827.3 +/- 123.3 and 514.0 +/- 111.3 days in patients with sinus rhythm, permanent/persistent AF, and attack of AF during first 10 days of ACS, respectively (p<0.001). Compared with patients in sinus rhythm in patients with attack of AF relative risk (RR) of occurrence of any end point was 1.75 (95% confidence interval [CI] 1.284 to 2.873, p< 0.001), of fatal MI - 1.72 (95% CI 1.026 to 2.873, p=0.040), of UA - 2.116 (95% CI 1.249 to 3.585, p=0.005), of stroke - 2.863 (95% CI 1.300 to 6.301, p=0.009). Multifactorial analysis selected history of MI and attack of AF during first 10 days of ACS as independent predictors of unfavorable outcome. Thus paroxysmal form of AF during hospital stay because of ACS is associated with higher probability of development of unfavorable events in the next 1-2 years.
为研究急性冠状动脉综合征（ACS）期间房颤（AF）对临床病情稳定后长期预后的影响，我们对莫斯科医院收治的453例患者进行了检查，并对他们进行了2.07±0.48年的随访。记录了以下事件：致命性和非致命性心肌梗死（MI）、不稳定型心绞痛（UA）、致命性和非致命性卒中、其他原因导致的死亡。在ACS发病时，419例（92.5%）患者为窦性心律，16例（3.5%）为永久性或持续性房颤，18例（4.0%）患者为房颤发作（阵发性）。在窦性心律、永久性/持续性房颤以及ACS发病后前10天内出现房颤发作的患者中，至终点前的平均寿命分别为884.9±23.4天、827.3±123.3天和514.0±111.3天（p<0.001）。与窦性心律患者相比，发生房颤发作的患者出现任何终点事件的相对风险（RR）为1.75（95%置信区间[CI]为1.284至2.873，p<0.001），致命性MI的RR为1.72（95%CI为1.026至2.873，p=0.040），UA的RR为2.116（95%CI为1.249至3.585，p=0.005），卒中的RR为2.863（95%CI为1.300至6.301，p=0.009）。多因素分析选择MI病史和ACS发病后前10天内的房颤发作作为不良结局的独立预测因素。因此，因ACS住院期间的阵发性房颤形式与未来1至2年内发生不良事件的较高概率相关。
