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急性心肌梗死中新发房颤的临床危险因素:一项系统评价和荟萃分析。

Clinical risk factors for new-onset atrial fibrillation in acute myocardial infarction: A systematic review and meta-analysis.

作者信息

He Jing, Yang Yi, Zhang Gui, Lu Xiu-Hong

机构信息

Guangdong Sanjiu Brain Hospital.

Guangdong Provincial Corps Hospital of Chinese People's Armed Police Forces, Guangzhou Medical University, Guangzhou, China.

出版信息

Medicine (Baltimore). 2019 Jun;98(26):e15960. doi: 10.1097/MD.0000000000015960.

Abstract

New-onset atrial fibrillation (NOAF) remains common arrhythmia in acute myocardial infarction (AMI), and is closely associated with increased subsequent cardiovascular mortality. Our meta-analysis aims to summarize more clinical risk factors for NOAF.Comprehensive systematic search of MEDLINE, EMBASE, and the Cochrane Library were carried out to find relevant studies inception to December 2017. Pooled mean difference (MD) and 95% confidence interval (CI) were calculated to evaluate the value of clinical risk factors in the prediction of NOAF after AMI.Eleven studies containing 9570 patients were included in the meta-analysis. Overall, older age and increased heart rate (HR) levels had a significant positive association with NOAF in patients with AMI. The MD in age between the patients with, and those without NOAF, was 8.22 units (95% confidence interval [CI]: 7.44-9.01), test for overall effect z score = 20.51 (P < .00001, I = 0%). Moreover, the MD in a subgroup analysis for HR levels between the patients with, and those without NOAF was 4.34 units (95% Cl: 2.56-6.11), test for overall effect z score = 4.78 (P < .00001, I = 31%).In patient with AMI, our meta-analysis demonstrated that older age and increased HR levels on admission are related to greater risk of NOAF.

摘要

新发心房颤动(NOAF)仍是急性心肌梗死(AMI)中常见的心律失常,并且与随后心血管死亡率增加密切相关。我们的荟萃分析旨在总结更多NOAF的临床危险因素。对MEDLINE、EMBASE和Cochrane图书馆进行了全面系统的检索,以查找截至2017年12月的相关研究。计算合并平均差(MD)和95%置信区间(CI),以评估临床危险因素在预测AMI后NOAF中的价值。荟萃分析纳入了11项研究,共9570例患者。总体而言,年龄较大和心率(HR)水平升高与AMI患者的NOAF呈显著正相关。有NOAF和无NOAF患者之间的年龄MD为8.22个单位(95%置信区间[CI]:7.44-9.01),总体效应检验z值=20.51(P<.00001,I=0%)。此外,有NOAF和无NOAF患者之间HR水平亚组分析的MD为4.34个单位(95%CI:2.56-6.11),总体效应检验z值=4.78(P<.00001,I=31%)。在AMI患者中,我们的荟萃分析表明,年龄较大和入院时HR水平升高与NOAF风险增加有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4df/6616519/f32f074f203d/medi-98-e15960-g001.jpg

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