近期发生房颤的个体中房颤类型的患病率及预测因素

Prevalence and predictors of atrial fibrillation type among individuals with recent onset of atrial fibrillation.

作者信息

Ruperti Repilado Francisco J, Doerig Laura, Blum Steffen, Aeschbacher Stefanie, Krisai Philipp, Ammann Peter, Erne Paul, Moschovitis Giorgio, di Valentino Marcello, Shah Dipen, Schläpfer Jürg, Stempfel Samuel, Kühne Michael, Sticherling Christian, Osswald Stefan, Conen David

机构信息

Division of Internal Medicine, Department of Medicine, University Hospital Basel, Switzerland, Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland.

Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland.

出版信息

Swiss Med Wkly. 2018 Sep 23;148:w14652. doi: 10.4414/smw.2018.14652. eCollection 2018 Sep 10.

DOI:10.4414/smw.2018.14652

PMID:30378644

Abstract

OBJECTIVE

Atrial fibrillation (AF) is considered to be a progressive disease, starting with intermittent episodes that progress over time to more sustained events. However, little is known about the prevalence of and predictors for AF type among patients with recent-onset AF. We aimed to address these issues among a selected population of patients with AF.

METHODS

The Basel atrial fibrillation cohort (BEAT-AF) study is an ongoing prospective multicentre cohort study among patients with AF. At baseline, we obtained information on the date of AF diagnosis, AF type, comorbidities, medication and lifestyle factors. For this analysis, 486 (31.4%) out of 1550 participants with recent-onset AF (defined as AF duration <24 months) were included. Predictors for AF type (non-paroxysmal vs paroxysmal) were obtained using multivariable adjusted logistic regression models.

RESULTS

Mean age was 67 (59-75) years and 136 (28%) were women. Recent-onset paroxysmal AF was observed in 301 (62%) participants, 185 (38%) had non-paroxysmal AF - persistent AF in 148 (30.4%) and permanent AF in 37 (7.6%). In multivariable models, odds ratios for having non-paroxysmal AF around AF diagnosis were 1.03 per year increasing in age (95% confidence interval [CI] 1.01-1.05, p = 0.01); 2.70 (1.5-4.68, p = 0.0004) for history of heart failure; 3.82 (1.05-13.87, p = 0.04) for a history of hyperthyroidism and 1.04 (1.02-1.05, p <0.0001) per beat increase in heart rate.

CONCLUSION

We found a substantial proportion of AF patients with the non-paroxysmal form shortly after diagnosis. Predictors for non-paroxysmal AF were increasing age, history of heart failure or hyperthyroidism, and a higher heart rate.

摘要

目的

心房颤动（AF）被认为是一种进行性疾病，始于间歇性发作，随着时间推移进展为更持续性的发作。然而，对于近期发生房颤的患者中房颤类型的患病率及预测因素知之甚少。我们旨在选定的房颤患者群体中解决这些问题。

方法

巴塞尔心房颤动队列（BEAT - AF）研究是一项正在进行的针对房颤患者的前瞻性多中心队列研究。在基线时，我们获取了房颤诊断日期、房颤类型、合并症、用药及生活方式因素等信息。本次分析纳入了1550名近期发生房颤（定义为房颤持续时间<24个月）的参与者中的486名（31.4%）。使用多变量调整逻辑回归模型获取房颤类型（非阵发性与阵发性）的预测因素。

结果

平均年龄为67（59 - 75）岁，女性136名（28%）。301名（62%）参与者为近期发生的阵发性房颤，185名（38%）为非阵发性房颤——其中148名（30.4%）为持续性房颤，37名（7.6%）为永久性房颤。在多变量模型中，房颤诊断时非阵发性房颤的比值比为年龄每增加一岁1.03（95%置信区间[CI] 1.01 - 1.05，p = 0.01）；心力衰竭病史者为2.70（1.5 - 4.68，p = 0.0004）；甲状腺功能亢进病史者为3.82（1.05 - 13.87，p = 0.04）；心率每增加一次搏动为1.04（1.02 - 1.05，p <0.0001）。