早发性心房颤动：临床特征、进展率和心血管结局的性别差异。
Young-onset atrial fibrillation: Sex differences in clinical profile, progression rate and cardiovascular outcome.
作者信息
Marcos Ernaldo G, De With Ruben R, Mulder Bart A, Van Gelder Isabelle C, Rienstra Michiel
机构信息
University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
出版信息
Int J Cardiol Heart Vasc. 2019 Nov 7;25:100429. doi: 10.1016/j.ijcha.2019.100429. eCollection 2019 Dec.
BACKGROUND
Women are underrepresented in major atrial fibrillation (AF) trials. In addition, data regarding clinical profile and outcome in young AF patients is limited. Therefore we aimed to investigate the clinical profile, AF progression rate and cardiovascular outcome between sexes in patients with young-onset AF.
METHODS
A total of 497 patients with AF-onset <60 years of age were included. Data on clinical profile and cardiovascular outcome were prospectively collected.
RESULTS
Of 497 patients, 125 (25%) patients were women. Women had more often familial AF (34% versus 22%, = 0.012) and obesity (26% versus 18%, = 0.03). Men had more often coronary artery disease (11% versus 5%, = 0.04), a longer PR interval [163 (148-180) versus 150 (138-167) ms, < 0.001] and higher left ventricular mass index [82 (71-96) versus 72 (61-83) g/m, < 0.001]. During a median follow-up of 7.0 (2.7-10.0) years AF progression rate was comparable (HR 2.03 for men versus women, 95%CI 0.92-4.48; = 0.08), and no difference in cardiovascular events was observed between women and men (Log rank -value = 0.07).
CONCLUSIONS
In young patients with AF, clinical patient profile is different between the sexes but did not result in differences in cardiovascular outcome.
背景
在主要的心房颤动（AF）试验中女性的参与率较低。此外，关于年轻AF患者的临床特征和预后的数据有限。因此，我们旨在研究年轻起病的AF患者中男女之间的临床特征、AF进展率和心血管预后。
方法
共纳入497例AF发病年龄<60岁的患者。前瞻性收集临床特征和心血管预后的数据。
结果
497例患者中，125例（25%）为女性。女性更常患有家族性AF（34%对22%，P=0.012）和肥胖（26%对18%，P=0.03）。男性更常患有冠状动脉疾病（11%对5%，P=0.04），PR间期更长[163（148-180）对150（138-167）ms，P<0.001]，左心室质量指数更高[82（71-96）对72（61-83）g/m²，P<0.001]。在中位随访7.0（2.7-10.0）年期间，AF进展率相当（男性与女性的HR为2.03，95%CI为0.92-4.48；P=0.08），且未观察到女性和男性之间心血管事件的差异（对数秩检验P值=0.07）。
结论
在年轻的AF患者中，男女之间的临床特征不同，但未导致心血管预后的差异。
Zotero 插件