Dipartimento di Medicina Clinica, Scienze Cardiovascolari ed Immunologiche, Cattedra di Geriatria, Università di Napoli Federico II, Via S. Pansini, 5, I-80131 Napoli, Italy.
Arch Gerontol Geriatr. 2012 Jul-Aug;55(1):91-5. doi: 10.1016/j.archger.2011.06.003. Epub 2011 Jun 30.
Permanent AF is characterized by an increased mortality in elderly subjects with CHF. Moreover, AF increased the risk of mortality also in elderly subjects without CHF. Thus, we examined long-term mortality in community-dwelling elderly people with and without CHF. A total of 1332 subjects aged 65 and older were selected from the electoral rolls of Campania, a region of southern Italy. The relationship between AF and mortality during a 12-year follow-up in 125 subjects with CHF and in 1.143 subjects without CHF were studied. Elderly subjects showed a higher mortality in those with respect to those without AF (72.1% vs. 51.8%; p<0.01). Similarly, elderly subjects without CHF showed a higher mortality in those with respect to those without AF (61.8% vs. 49.8%; p<0.05). In contrast, elderly subjects with CHF showed a similar mortality in those with respect to those without AF (74.7% vs. 82.4%; p=0.234). Multivariate analysis shows that AF was predictive of mortality in all elderly subjects (Hazard Risk=HR=1.39, 95% confidence interval (CI)=1.25-2.82; p<0.001). When the analysis was conducted considering the presence and the absence of CHF, AF was strongly predictive of mortality in elderly subjects without CHF (HR=1.95, 95%CI=1.25-4.51; p<0.001) but not in those with CHF (HR=1.12, 95%CI=0.97-3.69; p=0.321). We concluded that AF is able to predict long-term mortality in elderly subjects. Moreover, AF is strongly predictive of long-term mortality in the absence but not in the presence of CHF.
永久性房颤的特征是心力衰竭的老年患者死亡率增加。此外，房颤也增加了无心力衰竭的老年患者的死亡率。因此，我们检查了伴有和不伴有心力衰竭的社区居住的老年患者的长期死亡率。从意大利南部坎帕尼亚地区的选民名单中选择了 1332 名年龄在 65 岁及以上的受试者。研究了在 125 例心力衰竭患者和 1143 例无心力衰竭患者中，房颤与 12 年随访期间死亡率的关系。老年患者的死亡率在房颤患者中高于无房颤患者（72.1%对 51.8%；p<0.01）。同样，无心力衰竭的老年患者的死亡率在房颤患者中高于无房颤患者（61.8%对 49.8%；p<0.05）。相比之下，心力衰竭的老年患者的死亡率在房颤患者和无房颤患者之间没有差异（74.7%对 82.4%；p=0.234）。多变量分析表明，房颤是所有老年患者死亡的预测因素（风险比=HR=1.39，95%置信区间[CI]=1.25-2.82；p<0.001）。当分析考虑心力衰竭的存在和不存在时，房颤是无心力衰竭老年患者死亡的强烈预测因素（HR=1.95，95%CI=1.25-4.51；p<0.001），但不是心力衰竭患者（HR=1.12，95%CI=0.97-3.69；p=0.321）。我们得出结论，房颤能够预测老年患者的长期死亡率。此外，房颤在无心力衰竭的情况下强烈预测长期死亡率，但在心力衰竭的情况下则不然。
