Division of Nephrology, Taichung Veterans General Hospital, Taichung 407, Taiwan.
Graduate Institute of Public Health, China Medical University, Taichung 404, Taiwan.
Int J Environ Res Public Health. 2018 Sep 21;15(10):2082. doi: 10.3390/ijerph15102082.
: 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.
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。