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颈椎病患者心律失常的关联:一项基于全国人口的队列研究。

Association of Arrhythmia in Patients with Cervical Spondylosis: A Nationwide Population-Based Cohort Study.

作者信息

Lin Shih-Yi, Hsu Wu-Huei, Lin Cheng-Chieh, Lin Cheng-Li, Tsai Chun-Hao, Lin Chih-Hsueh, Chen Der-Cherng, Lin Tsung-Chih, Hsu Chung-Y, Kao Chia-Hung

机构信息

Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung 404, Taiwan.

Division of Nephrology and Kidney Institute, China Medical University Hospital, Taichung 404, Taiwan.

出版信息

J Clin Med. 2018 Aug 23;7(9):236. doi: 10.3390/jcm7090236.

Abstract

BACKGROUND

Sympathetic activity, including cervical ganglia, is involved in the development of cardiac arrhythmias.

OBJECTIVE

The present study investigated the association between cervical spondylosis and arrhythmia, which has never been reported before.

METHODS

Patients newly diagnosed with cervical spondylosis (CS) with an index date between 2000 and 2011 were identified from the National Health Insurance Research Database. We performed a 1:1 case-control matched analysis. Cases were matched to controls according to their estimated propensity scores, based on demographics and existing risk factors. Cox proportional hazard models were applied to assess the association between CS and arrhythmia.

RESULTS

The CS cohort comprised 22,236 patients (males, 42.6%; mean age, 54.4 years) and non-CS cohort comprised 22,236 matched controls. There were 1441 events of arrhythmia in CS cohort and 537 events of arrhythmia in non-CS cohort, which 252 and 127 events of atrial fibrillation in CS and non-CS cohort, 33 and 12 events of ventricular tachycardia in CS cohort and non-CS cohort, 78 and 35 events of supraventricular tachycardia in CS cohort and non-CS cohort. The CS cohort had an arrhythmia incidence of 11.1 per 1000 person-years and a higher risk [adjusted hazard ratio (aHR) = 3.10, 95% confidence interval (CI) = 2.80⁻3.42] of arrhythmia, 2.54-fold aHR of ventricular tachycardia (95% CI = 1.70⁻3.79), and 2.22-fold aHR of atrial fibrillation (95% CI = 1.79⁻2.76) compared with non-CS cohort.

CONCLUSIONS

Cervical spondylosis is associated with a higher risk of arrhythmia.

摘要

背景

包括颈神经节在内的交感神经活动与心律失常的发生有关。

目的

本研究调查了颈椎病与心律失常之间的关联,此前从未有过相关报道。

方法

从国民健康保险研究数据库中识别出2000年至2011年期间确诊为颈椎病(CS)且有索引日期的患者。我们进行了1:1病例对照匹配分析。根据人口统计学和现有风险因素,根据估计的倾向得分将病例与对照进行匹配。应用Cox比例风险模型评估CS与心律失常之间的关联。

结果

CS队列包括22236名患者(男性占42.6%;平均年龄54.4岁),非CS队列包括22236名匹配对照。CS队列中有1441例心律失常事件,非CS队列中有537例心律失常事件,其中CS队列和非CS队列分别有252例和127例房颤事件,CS队列和非CS队列分别有33例和12例室性心动过速事件,CS队列和非CS队列分别有78例和35例室上性心动过速事件。CS队列的心律失常发病率为每1000人年11.1例,心律失常风险更高[调整后风险比(aHR)=3.10,95%置信区间(CI)=2.80⁻3.42],室性心动过速的aHR为2.54倍(95%CI=1.70⁻3.79),房颤的aHR为2.22倍(95%CI=1.79⁻2.76)与非CS队列相比。

结论

颈椎病与心律失常风险较高有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c53/6162845/2f229226e459/jcm-07-00236-g001.jpg

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