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急性心肌梗死患者心房颤动的预测与转归

Predictions and Outcomes of Atrial Fibrillation in the Patients with Acute Myocardial Infarction.

作者信息

Vukmirović Mihailo, Bošković Aneta, Tomašević Vukmirović Irena, Vujadinovic Radoje, Fatić Nikola, Bukumirić Zoran, Vukmirović Filip

机构信息

Department of Cardiology, Clinical Center of Montenegro, Montenegro, 20000 Podgorica.

Department of Radiology, Clinical Center of Montenegro, Montenegro, 20000 Podgorica.

出版信息

Open Med (Wars). 2017 May 2;12:115-124. doi: 10.1515/med-2017-0018. eCollection 2017.

Abstract

The large epidemiological studies demonstrated that atrial fibrillation is correlated with high mortality and adverse events in patients with acute myocardial infarction. The aim of this study was to determinate predictors of atrial fibrillation develop during the hospital period in patients with acute myocardial infarction as well as short- and long-term mortality depending on the atrial fibrillation presentation. The 600 patients with an acute myocardial infarction were included in the study and follow-up 84 months. Atrial fibrillation develops during the hospital period was registered in 48 patients (8%). After adjustment by logistic regression model the strongest predictor of atrial fibrillation develop during the hospital period was older age, particularly more than 70 years (odds ratio 2.37, CI 1.23-4.58, p=0.010), followed by increased of Body Mass Index (odds ratio 1.17, CI 1.04-1.33, p=0.012), enlarged diameter of left atrium (LA) (odds ratio 1,18, CI 1,03-1,33, p=0,015) presentation of mitral regurgitation (odds ratio 3.56, CI 1.25-10.32, p=0.018) and B-type natriuretic peptide (odds ratio 2.12, CI 1.24-3.33, p=0.048).Patients with atrial fibrillation develop during the hospital period had a higher mortality during the hospital course (10.4% vs. 5.6%) p=0.179. as well as follow-up period of 84 months than patients without it (64.6% vs. 39.1%) p=0.569, than patients without it, but without statistically significance. Patients with AF develop during the hospital period had higher mortality during the hospital course as well as follow up period of 84 months than patients without it, but without statistically significance.

摘要

大型流行病学研究表明,心房颤动与急性心肌梗死患者的高死亡率和不良事件相关。本研究的目的是确定急性心肌梗死患者在住院期间发生心房颤动的预测因素,以及根据心房颤动的表现确定短期和长期死亡率。本研究纳入了600例急性心肌梗死患者,并进行了84个月的随访。48例患者(8%)在住院期间发生了心房颤动。经逻辑回归模型调整后,住院期间发生心房颤动的最强预测因素是年龄较大,尤其是70岁以上(比值比2.37,可信区间1.23 - 4.58,p = 0.010),其次是体重指数升高(比值比1.17,可信区间1.04 - 1.33,p = 0.012)、左心房(LA)直径增大(比值比1.18,可信区间1.03 - 1.33,p = 0.015)、二尖瓣反流表现(比值比3.56,可信区间1.25 - 10.32,p = 0.018)和B型利钠肽(比值比2.12,可信区间1.24 - 3.33,p = 0.048)。在住院期间发生心房颤动的患者在住院期间的死亡率较高(10.4%对5.6%),p = 0.179,在84个月的随访期内也高于未发生心房颤动的患者(64.6%对39.1%),p = 0.569,但无统计学意义。在住院期间发生心房颤动的患者在住院期间以及84个月的随访期内的死亡率均高于未发生心房颤动的患者,但无统计学意义。

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