肝硬化患者心房颤动的流行病学及临床意义：一项荟萃分析。

Epidemiology of atrial fibrillation in patients with cirrhosis and clinical significance: a meta-analysis.

作者信息

Chokesuwattanaskul Ronpichai, Thongprayoon Charat, Bathini Tarun, O'Corragain Oisin A, Sharma Konika, Preechawat Somchai, Wijarnpreecha Karn, Kröner Paul T, Ungprasert Patompong, Cheungpasitporn Wisit

机构信息

Department of Medicine, Division of Cardiology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society.

Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.

出版信息

Eur J Gastroenterol Hepatol. 2019 Apr;31(4):514-519. doi: 10.1097/MEG.0000000000001315.

DOI:10.1097/MEG.0000000000001315

PMID:30451705

Abstract

OBJECTIVE

The epidemiology of atrial fibrillation (AF) in patients with cirrhosis and its clinical significance remain unclear. This study aimed (i) to investigate the pooled prevalence and/or incidence of AF in patients with cirrhosis and (ii) to assess the mortality risk of AF in patients with cirrhosis.

PATIENTS AND METHODS

A literature search for studies that reported incidence of AF in patients with cirrhosis was carried out using Medline, Embase, and Cochrane Database from inception through July 2018. Pooled incidence with 95% confidence interval (CI) was calculated using a random-effect model. The protocol for this meta-analysis is registered with PROSPERO (International Prospective Register of Systematic Reviews; no. CRD42018102664).

RESULTS

Seven cohort studies including 385 866 patients with cirrhosis were identified. The pooled estimated prevalence of AF in patients with cirrhosis was 5.0% (95% CI: 2.8-8.6%). When studies that solely assessed patients undergoing transplant evaluation or on transplant waiting list were excluded, the pooled estimated prevalence of AF in patients with cirrhosis was 7.4% (95% CI: 3.5-15.2%). There was a significant association between AF and increased mortality risk in cirrhotic patients with a pooled odds ratio of 1.44 (95% CI: 1.36-1.53).

CONCLUSION

The overall estimated prevalence of AF among patients with cirrhosis is 5.0%. Our study demonstrates a statistically significant increased mortality risk in cirrhotic patients with AF.

摘要

目的

肝硬化患者心房颤动（AF）的流行病学及其临床意义仍不明确。本研究旨在（i）调查肝硬化患者AF的合并患病率和/或发病率，以及（ii）评估肝硬化患者AF的死亡风险。

患者与方法

使用Medline、Embase和Cochrane数据库，对从创刊至2018年7月期间报道肝硬化患者AF发病率的研究进行文献检索。采用随机效应模型计算合并发病率及95%置信区间（CI）。本荟萃分析方案已在国际前瞻性系统评价注册库（PROSPERO；注册号CRD42018102664）登记。

结果

共纳入7项队列研究，涉及385866例肝硬化患者。肝硬化患者AF的合并估计患病率为5.0%（95%CI：2.8 - 8.6%）。排除仅评估接受移植评估或在移植等待名单上患者的研究后，肝硬化患者AF的合并估计患病率为7.4%（95%CI：3.5 - 15.2%）。AF与肝硬化患者死亡风险增加之间存在显著关联，合并比值比为1.44（95%CI：1.36 - 1.53）。