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风险因素和合并症对心房颤动发病率的影响

The Impact of Risk Factors and Comorbidities on The Incidence of Atrial Fibrillation.

作者信息

Naser Nabil, Dilic Mirza, Durak Azra, Kulic Mehmed, Pepic Esad, Smajic Elnur, Kusljugic Zumreta

机构信息

Polyclinic "Dr. Nabil", Sarajevo, Bosnia and Herzegovina.

Clinic for Heart Disease, Blood Vessels and Rheumathism, University Clinical Center Sarajevo, Bosnia and Herzegovina.

出版信息

Mater Sociomed. 2017 Dec;29(4):231-236. doi: 10.5455/msm.2017.29.231-236.

Abstract

INTRODUCTION

Atrial fibrillation (AF) is the most common form of cardiac arrhythmia in clinical practice and its prevalence increases with age. Patients who develop AF also have cardiovascular risk factors, structural heart disease, and comorbidities, all of which can increase mortality. AF causes a significant economic burden with the increasing trend in AF prevalence and hospitalizations.

RESEARCH OBJECTIVES

The objective of our study is to evaluate the impact of the most common known risk factors on the incidence of atrial fibrillation as an important precursor of cardiac and cerebrovascular morbidity and mortality among our patients in Bosnia and Herzegovina during median follow up period (September 2006 - September 2016). The other objective is to estimate the CHA2DS2-VASc score among our patients based on clinical parameters.

PATIENTS AND METHODS

This study includes 2352 ambulant and hospitalized patients with atrial fibrillation. All patients underwent clinical evaluation which includes thorough assessment for potential risk factors and concomitant conditions in order to determine which of them represent the most common among examinees with atrial fibrillation.

RESULTS

The results show that male gender has slightly more incidence of AF. Obesity and overweight with BMI ≥ 27, cigarettes smoking and sedentary life style are almost present in patients with AF. Arterial hypertension, coronary artery disease, diabetes mellitus, chronic obstructive pulmonary disease, chronic renal dysfunction, structural and valvular heart disease and peripheral vascular disease are the most common comorbidities among our patients. The mean CHA2DS2-VASc score was 3.2±1.4 and the mean HAS-BLED score was 2.1±1.2.

CONCLUSION

Atrial fibrillation is the most common sustained cardiac rhythm disorder. The study shows that obesity, alcohol consumption, smoking cigarettes and dyslipidemia can be considered as triggers and predisposing factors for appearance of AF. Arterial hypertension, coronary artery disease, chronic obstructive pulmonary disease, diabetes mellitus, Peripheral vascular disease and chronic kidney disease are playing important role in developing of AF.

摘要

引言

心房颤动(AF)是临床实践中最常见的心律失常形式,其患病率随年龄增长而增加。发生房颤的患者还伴有心血管危险因素、结构性心脏病和合并症,所有这些都会增加死亡率。随着房颤患病率和住院率呈上升趋势,房颤造成了巨大的经济负担。

研究目的

我们研究的目的是评估最常见的已知危险因素对心房颤动发病率的影响,心房颤动是波斯尼亚和黑塞哥维那患者在中位随访期(2006年9月至2016年9月)中心脑血管发病和死亡的重要先兆。另一个目的是根据临床参数估计我们患者的CHA2DS2-VASc评分。

患者与方法

本研究纳入2352例门诊和住院的心房颤动患者。所有患者均接受了临床评估,包括对潜在危险因素和伴随疾病的全面评估,以确定哪些因素在房颤患者中最为常见。

结果

结果显示,男性房颤发病率略高。房颤患者中几乎都存在肥胖和超重(BMI≥27)、吸烟和久坐的生活方式。动脉高血压、冠状动脉疾病、糖尿病、慢性阻塞性肺疾病、慢性肾功能不全、结构性和瓣膜性心脏病以及外周血管疾病是我们患者中最常见的合并症。平均CHA2DS2-VASc评分为3.2±1.4,平均HAS-BLED评分为2.1±1.2。

结论

心房颤动是最常见的持续性心律失常。研究表明,肥胖、饮酒、吸烟和血脂异常可被视为房颤出现的触发因素和易感因素。动脉高血压、冠状动脉疾病、慢性阻塞性肺疾病、糖尿病、外周血管疾病和慢性肾病在房颤的发生发展中起重要作用。

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