Division of Cardiology, Yonsei University College of Medicine, Seoul, Korea.
Division of Cardiology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
Sci Rep. 2017 Oct 5;7(1):12716. doi: 10.1038/s41598-017-13061-4.
In addition to being an established complicating factor for myocardial infarction (MI), recent studies have revealed that atrial fibrillation (AF) increased risk of MI. This study is to evaluate the risk of MI associated with AF in a nationwide population based cohort. We examine the association between AF and incident MI in 497,366 adults from the Korean National Health Insurance Service database, who were free of AF and MI at baseline. AF group (n = 3,295) was compared with propensity matched no-AF group (n = 13,159). Over 4.2 years of follow up, 137 MI events occurred. AF was associated with 3-fold increased risk of MI (HR, 3.1; 95% CI, 2.22-4.37) in both men (HR, 2.91; 95% CI 1.91-4.45) and women (HR, 3.52; 95% CI 2.01-6.17). The risk of AF-associated MI was higher in patients free of hypertension, diabetes, ischemic stroke, and dyslipidemia at baseline. The cumulative incidence of AF-associated MI was lower in patients on anticoagulant and statin therapies. Our finding suggests that AF complications beyond stoke should extend to total mortality to include MI.
除了是心肌梗死（MI）的既定并发症外，最近的研究还表明，心房颤动（AF）增加了 MI 的风险。本研究旨在评估在全国人群队列中，AF 与 MI 相关的风险。我们检查了来自韩国国家健康保险服务数据库的 497366 名成年人中 AF 与新发 MI 之间的关联，这些人在基线时无 AF 和 MI。AF 组（n=3295）与倾向评分匹配的无 AF 组（n=13159）进行比较。在 4.2 年的随访期间，发生了 137 例 MI 事件。在男性（HR，2.91；95%CI，1.91-4.45）和女性（HR，3.52；95%CI，2.01-6.17）中，AF 与 MI 风险增加 3 倍相关。在基线时无高血压、糖尿病、缺血性卒中和血脂异常的患者中，AF 相关 MI 的风险更高。在接受抗凝和他汀类药物治疗的患者中，AF 相关 MI 的累积发生率较低。我们的发现表明，AF 并发症除了中风外，还应扩展到包括 MI 的总死亡率。
