Maan Abhishek, Shaikh Amir Y, Mansour Moussa, Ruskin Jeremy N, Heist E Kevin
Department of Internal Medicine, University of Massachusetts Medical School, Worcester, MA 01655.
Cardiac Arrhythmia Service, Massachusetts General Hospital and Harvard Medical School, GRB 109, 55 Fruit St, Boston MA 02115.
J Atr Fibrillation. 2012 Jun 15;5(1):586. doi: 10.4022/jafib.586. eCollection 2012 Jun-Jul.
Atrial fibrillation (AF) is the most common arrhythmia encountered in the U.S. and the growing burden of AF has profound health implications due to the association of AF with an increased risk of stroke, heart failure, and mortality. AF is a significant risk factor for thromboembolic stroke; and also independently increases total mortality in patients with and without cardiovascular disease. Various risk stratification schemes such as CHADS and CHADS-VASc have been implemented in clinical practice to determine the risk of cardio-embolic stroke, and need for thrombo-prophylaxis in patients with AF. AF is also closely related to the pathophysiology of other cardiovascular and peripheral vascular disease. Many patients with AF have associated atherosclerosis given that many risk factors for atherosclerosis also predispose to AF. Myocardial infarction (MI) is also closely related to AF and its clinical course is affected by new onset AF. This review elucidates the impact of AF on major adverse cardiovascular events and mortality outcomes in relation to stroke, coronary artery disease and peripheral vascular disease.
心房颤动（AF）是美国最常见的心律失常，由于AF与中风、心力衰竭和死亡率增加相关，其不断增加的负担对健康具有深远影响。AF是血栓栓塞性中风的重要危险因素；并且还独立增加有或没有心血管疾病患者的总死亡率。临床实践中已实施各种风险分层方案，如CHADS和CHADS-VASc，以确定心源性栓塞性中风的风险以及AF患者进行血栓预防的必要性。AF还与其他心血管和外周血管疾病的病理生理学密切相关。鉴于动脉粥样硬化的许多危险因素也易患AF，许多AF患者伴有动脉粥样硬化。心肌梗死（MI）也与AF密切相关，其临床病程受新发AF的影响。本综述阐明了AF对与中风、冠状动脉疾病和外周血管疾病相关的主要不良心血管事件和死亡率结局的影响。
