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晕厥和昏倒与透析患者心血管疾病风险和死亡率增加相关。

Syncope and Collapse Are Associated with an Increased Risk of Cardiovascular Disease and Mortality in Patients Undergoing Dialysis.

机构信息

Division of Nephrology, Taichung Veterans General Hospital, Taichung 407, Taiwan.

Graduate Institute of Public Health, China Medical University, Taichung 404, Taiwan.

出版信息

Int J Environ Res Public Health. 2018 Sep 21;15(10):2082. doi: 10.3390/ijerph15102082.

Abstract

: This study explored the impact of syncope and collapse (SC) on cardiovascular events and mortality in patients undergoing dialysis. : Patients undergoing dialysis with SC ( = 3876) were selected as the study cohort and those without SC who were propensity score-matched at a 1:1 ratio were included as controls. Major adverse cardiovascular events (MACEs), including acute coronary syndrome (ACS), arrhythmia or cardiac arrest, stroke, and overall mortality, were evaluated and compared in both cohorts. : The mean follow-up periods until the occurrence of ACS, arrhythmia or cardiac arrest, stroke, and overall mortality in the SC cohort were 3.51 ± 2.90, 3.43 ± 2.93, 3.74 ± 2.97, and 3.76 ± 2.98 years, respectively. Compared with the patients without SC, those with SC had higher incidence rates of ACS (30.1 vs. 24.7 events/1000 people/year), arrhythmia or cardiac arrest (6.75 vs. 3.51 events/1000 people/year), and stroke (51.6 vs. 35.7 events/1000 people/year), with higher overall mortality (127.7 vs. 77.9 deaths/1000 people/year). The SC cohort also had higher risks for ACS, arrhythmia or cardiac arrest, stroke, and overall mortality (adjusted hazard ratios: 1.28 (95% confidence interval (CI) = 1.11⁻1.46), 2.05 (95% CI = 1.50⁻2.82), 1.48 (95% CI = 1.33⁻1.66), and 1.79 (95% CI = 1.67⁻1.92), respectively) than did the non-SC cohort. : SC was significantly associated with cardiovascular events and overall mortality in the patients on dialysis. SC may serve as a prodrome for cardiovascular comorbidities, thereby assisting clinicians in identifying high-risk patients.

摘要

这项研究探讨了晕厥和跌倒(SC)对透析患者心血管事件和死亡率的影响。选择有 SC 的透析患者(=3876 例)作为研究队列,并按 1:1 比例进行倾向评分匹配无 SC 的患者作为对照。评估和比较了两组主要不良心血管事件(MACEs),包括急性冠状动脉综合征(ACS)、心律失常或心搏骤停、卒中和总死亡率。SC 组发生 ACS、心律失常或心搏骤停、卒中和总死亡率的平均随访期分别为 3.51±2.90、3.43±2.93、3.74±2.97 和 3.76±2.98 年。与无 SC 的患者相比,有 SC 的患者 ACS(30.1 比 24.7 例/1000 人/年)、心律失常或心搏骤停(6.75 比 3.51 例/1000 人/年)和卒中等发生率更高(51.6 比 35.7 例/1000 人/年),总死亡率也更高(127.7 比 77.9 例/1000 人/年)。SC 组发生 ACS、心律失常或心搏骤停、卒中和总死亡率的风险也更高(调整后的危险比:1.28(95%置信区间(CI)=1.11⁻1.46)、2.05(95% CI=1.50⁻2.82)、1.48(95% CI=1.33⁻1.66)和 1.79(95% CI=1.67⁻1.92))。与非 SC 组相比。因此,SC 与透析患者的心血管事件和总死亡率显著相关。SC 可能是心血管合并症的先兆,有助于临床医生识别高危患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a54f/6210976/65363f642d06/ijerph-15-02082-g001.jpg

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