Internal Medicine Section of Cardiology, University of Nebraska Medical Center, Omaha, NE, USA.
Bone Marrow Transplant. 2013 Jul;48(7):963-5. doi: 10.1038/bmt.2012.253. Epub 2012 Dec 10.
The use of autologous hematopoietic SCT (auto-HSCT) has expanded to include older patients. Increasing age is a well-appreciated risk factor for the development of atrial fibrillation and/or atrial flutter (AF/AFL) in the general population. As more elderly patients undergo auto-HSCT, the risk of developing AF/AFL post transplant may also increase. However, few data evaluating other risk factors for the development of AF/AFL following auto-HSCT exist. Therefore, we performed a retrospective study to determine the incidence of AF/AFL following auto-HSCT and to determine the risk factors associated with the development of AF/AFL. Patients who developed AF/AFL were compared with a group of patients who received auto-HSCT within the same time period (April 1999 to May 2005) and were within 5 years of age. Of the 516 patients who underwent auto-HSCT at the University of Nebraska Medical Center 44 (8.5%) developed AF/AFL at a median time of 4 days (range, days 1-9) following auto-HSCT. In multivariate analysis, risk factors for developing AF/AFL were older age, odds ratio and 95% CI of 1.14 (1.07-1.21), elevated serum creatinine level, 2.69 (1.00-7.22), history of previous arrhythmia, 9.33 (3.01-28.99), and history of previous mediastinal irradiation, 11.12 (1.33-92.96).
自体造血干细胞移植（auto-HSCT）的应用已经扩展到包括老年患者。年龄增长是普通人群发生心房颤动和/或心房扑动（AF/AFL）的一个公认的危险因素。随着越来越多的老年患者接受 auto-HSCT，移植后发生 AF/AFL 的风险也可能增加。然而，评估 auto-HSCT 后发生 AF/AFL 的其他危险因素的数据很少。因此，我们进行了一项回顾性研究，以确定 auto-HSCT 后发生 AF/AFL 的发生率，并确定与 AF/AFL 发展相关的危险因素。发生 AF/AFL 的患者与同一时期（1999 年 4 月至 2005 年 5 月）接受 auto-HSCT 且年龄相差不超过 5 岁的一组患者进行比较。在接受内布拉斯加大学医学中心 auto-HSCT 的 516 名患者中，有 44 名（8.5%）在 auto-HSCT 后中位时间 4 天（范围 1-9 天）发生 AF/AFL。在多变量分析中，发生 AF/AFL 的危险因素是年龄较大、优势比和 95%可信区间为 1.14（1.07-1.21）、血清肌酐水平升高、2.69（1.00-7.22）、既往心律失常史、9.33（3.01-28.99）和既往纵隔照射史、11.12（1.33-92.96）。
