From the Department of Cardiology, Atrial Fibrillation Study Group, Aalborg University Hospital, Aalborg, Denmark (L.M., F.S.T.B.L); Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Faculty of Health, Aalborg University, Aalborg, Denmark (L.H.R., F.S., G.Y.H.L., T.B.L.); and University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, UK (G.Y.H.L.).
Stroke. 2014 May;45(5):1331-7. doi: 10.1161/STROKEAHA.114.004903. Epub 2014 Mar 27.
The risk of stroke and death in patients with atrial fibrillation is strongly associated with age and concomitant comorbidities. The aim of this study was to examine the age dependence of risk factors for stroke and mortality in young patients with atrial fibrillation.
This study is a population-based cohort study of 30- to 65-year-old patients with atrial fibrillation and diagnosed during 2000 to 2011, identified by record linkage between nationwide Danish registries. Cox regression models were used to estimate the risk of stroke and mortality according to risk factors within age groups: 30 to 50, 50 to 65, and 65 to 75 years.
We identified 73,799 nonvalvular atrial fibrillation patients, of which 37,782 (51.2%) were <65 years old (mean age 62.8). A higher modified cardiac failure or dysfunction, hypertension, age 75 (doubled), diabetes, stroke (doubled), vascular disease, age 65-74 and sex category (female) score (CHA2DS2-VASc score) was associated with decreased survival probability in all age groups. The overall incidence of stroke per year for 1 year (5 years) follow-up was 1.2% (0.6%), 3.5% (1.6%), and 5.6% (2.8%), respectively, for the age groups of 30 to 50, 50 to 65, and 65 to 75. Overall, risk factors such as previous stroke, heart failure, vascular disease, diabetes mellitus, and hypertension remained independent predictors of stroke and death in patients<65 years old with nonvalvular atrial fibrillation.
The CHA2DS2-VASc score is an applicable tool for all age groups and in nonvalvular atrial fibrillation patients<65 years old, the same risk factors apply.
房颤患者的中风和死亡风险与年龄和并存的合并症密切相关。本研究旨在探讨年轻房颤患者中风和死亡风险的危险因素与年龄的关系。
这是一项基于人群的队列研究，纳入了 2000 年至 2011 年间通过全国丹麦登记处的记录链接确定的 30 至 65 岁的非瓣膜性房颤患者。使用 Cox 回归模型根据年龄组内的危险因素来估计中风和死亡率：30 至 50 岁、50 至 65 岁和 65 至 75 岁。
我们共纳入了 73799 例非瓣膜性房颤患者，其中 37782 例（51.2%）年龄<65 岁（平均年龄 62.8 岁）。较高的改良心脏衰竭或功能障碍、高血压、75 岁（翻倍）、糖尿病、中风（翻倍）、血管疾病、65-74 岁和性别类别（女性）评分（CHA2DS2-VASc 评分）与所有年龄组的生存率降低相关。在 30 至 50 岁、50 至 65 岁和 65 至 75 岁年龄组，1 年（5 年）随访期间的中风总体发生率分别为 1.2%（0.6%）、3.5%（1.6%）和 5.6%（2.8%）。总的来说，对于年龄<65 岁的非瓣膜性房颤患者，既往中风、心力衰竭、血管疾病、糖尿病和高血压等危险因素仍然是中风和死亡的独立预测因素。
CHA2DS2-VASc 评分适用于所有年龄组，在年龄<65 岁的非瓣膜性房颤患者中，同样的危险因素适用。
