中国老年人群中心房颤动的患病率、发病率、管理及风险：一项前瞻性研究。
The prevalence, incidence, management and risks of atrial fibrillation in an elderly Chinese population: a prospective study.
作者信息
Li Li-Hua, Sheng Chang-Sheng, Hu Bang-Chuan, Huang Qi-Fang, Zeng Wei-Fang, Li Ge-Le, Liu Ming, Wei Fang-Fei, Zhang Lu, Kang Yuan-Yuan, Song Jie, Wang Shuai, Li Yan, Liu Shao-Wen, Wang Ji-Guang
机构信息
Centre for Epidemiological Studies and Clinical Trials, Shanghai Key Laboratory of Hypertension, The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China.
Department of Cardiology, Shanghai First People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
出版信息
BMC Cardiovasc Disord. 2015 May 8;15:31. doi: 10.1186/s12872-015-0023-3.
BACKGROUND
There is limited information on prevalent and incident atrial fibrillation in Chinese. We aimed to investigate the prevalence, incidence, management and risks of atrial fibrillation in an elderly Chinese population.
METHODS
In a population--based prospective study in elderly (≥ 60 years) Chinese, we performed cardiovascular health examinations including a 12-lead electrocardiogram at baseline in 3,922 participants and biennially during follow-up in 2,017 participants. We collected information on vital status during the whole follow-up period.
RESULTS
The baseline prevalence of atrial fibrillation was 2.0 % (n = 34) in 1718 men and 1.6 % (n = 36) in 2204 women. During a median 3.8 years of follow-up, the incidence rate of atrial fibrillation (n = 34) was 4.9 per 1000 person-years (95 % confidence interval [CI], 3.4-6.9). In univariate analysis, both the prevalence and incidence of atrial fibrillation were higher with age advancing (P < 0.0001) and in the presence of coronary heart disease (P ≤ 0.02). Of the 104 prevalent and incident cases of atrial fibrillation, only 1 (1.0 %) received anticoagulant therapy (warfarin). These patients with atrial fibrillation, compared with those with sinus rhythm, had significantly higher risks of all-cause (n = 261, hazard ratio [HR] 1.87, 95 % CI, 1.09-3.20, P = 0.02), cardiovascular (n = 136, HR 3.78, 95 % CI 2.17-6.58, P < 0.0001) and stroke mortality (n = 44, HR 6.31, 95 % CI 2.81-14.19, P = 0.0003).
CONCLUSIONS
Atrial fibrillation was relatively frequent in elderly Chinese, poorly managed and associated with higher risks of mortality.
背景
关于中国人群中心房颤动的患病率和发病率的信息有限。我们旨在调查中国老年人群中心房颤动的患病率、发病率、管理情况及风险。
方法
在一项针对中国老年（≥60岁）人群的基于人群的前瞻性研究中，我们对3922名参与者进行了包括基线12导联心电图在内的心血管健康检查，并对2017名参与者在随访期间每两年进行一次检查。我们收集了整个随访期间的生命状态信息。
结果
1718名男性中心房颤动的基线患病率为2.0%（n = 34），2204名女性中为1.6%（n = 36）。在中位3.8年的随访期间，心房颤动的发病率（n = 34）为每1000人年4.9例（95%置信区间[CI]，3.4 - 6.9）。在单因素分析中，心房颤动的患病率和发病率均随年龄增长（P < 0.0001）以及冠心病的存在（P ≤ 0.02）而升高。在104例心房颤动的现患和新发病例中，只有1例（1.0%）接受了抗凝治疗（华法林）。与窦性心律者相比，这些心房颤动患者的全因死亡（n = 261，风险比[HR] 1.87，95% CI，1.09 - 3.20，P = 0.02）、心血管死亡（n = 136，HR 3.78，95% CI 2.17 - 6.58，P < 0.0001）和卒中死亡风险（n = 44，HR 6.31，95% CI 2.81 - 14.19，P = 0.0003）显著更高。
结论
心房颤动在中国老年人中较为常见，管理不善且与较高的死亡风险相关。
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