Yoshizaki Tohru, Umetani Ken, Ino Yuri, Takahashi Souichirou, Nakamura Masahiko, Seto Toshikuni, Aizawa Kazunori
Cardiology Department, Yamanashi Prefectural Central Hospital, Japan.
Intern Med. 2012;51(12):1467-71. doi: 10.2169/internalmedicine.51.7312. Epub 2012 Jun 15.
The purpose of this study was to investigate the relationship between the new onset of atrial fibrillation (AF) and inflammation in the early phase of acute myocardial infarction (AMI). Background Serial interaction between inflammation and the incidence of AF is not fully understood in the early phase of AMI.
Two hundred fifty-nine consecutive patients with AMI were studied. electrocardiogram monitoring was recorded continuously for >7 days. Serial inflammation markers, cardiac enzymes, coronary angiogram and echocardiography were obtained in all patients.
One hundred seventy-six patients were enrolled. AF was present in 24 patients (14%), and occurred on day 2.7 ± 1.4 after admission. Serial measurements of WBC and C-reactive protein (CRP) with/without AF were as follows. WBC levels of day 5-7 were 9.3 ± 3.5 vs. 7.5 ± 2.4 × 10(3)/µL, p=0.04, and CRP levels of day 2-4, 5-7, 8-14 were 12.6 ± 9.4 vs. 4.7 ± 5.3 mg/dL, p<0.001, 12.3 ± 10.4 vs. 5.2 ± 5.2 mg/dL, p=0.01, and 8.5 ± 7.7 vs. 2.7 ± 4.2 mg/dL, p=0.005, respectively. Those were significantly higher in the patients with AF. In multivariate logistic regression analysis, CRP levels of day 2-4 were independently higher in the patients with AF (odds ratio (OR) 1.15, 95% confidence (CI) 1.04-1.27).
AF in the early phase of AMI occurs a few days after the onset of AMI, which is independently related to the activated inflammation. AF in this period persists for only a short duration.
本研究旨在探讨急性心肌梗死（AMI）早期新发房颤（AF）与炎症之间的关系。背景：在AMI早期，炎症与AF发生率之间的系列相互作用尚未完全明确。
对259例连续的AMI患者进行研究。连续记录心电图监测>7天。所有患者均检测系列炎症标志物、心肌酶、冠状动脉造影和超声心动图。
纳入176例患者。24例（14%）患者发生AF，于入院后2.7±1.4天出现。伴/不伴AF患者的白细胞（WBC）和C反应蛋白（CRP）系列测量结果如下。第5 - 7天的WBC水平分别为9.3±3.5与7.5±2.4×10³/µL，p = 0.04；第2 - 4天、5 - 7天、8 - 14天的CRP水平分别为12.6±9.4与4.7±5.3mg/dL，p<0.001，12.3±10.4与5.2±5.2mg/dL，p = 0.01，8.5±7.7与2.7±4.2mg/dL，p = 0.005。AF患者的这些指标显著更高。多因素逻辑回归分析显示，AF患者第2 - 4天的CRP水平独立升高（比值比（OR）1.15，95%置信区间（CI）1.04 - 1.27）。
AMI早期的AF在AMI发病几天后出现，与炎症激活独立相关。此期AF仅持续较短时间。
