The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China.
Clin Cardiol. 2020 Jun;43(6):647-651. doi: 10.1002/clc.23363. Epub 2020 Apr 14.
This study aims to estimate prognostic indicators of new onset atrial fibrillation (AF) in patients with acute coronary syndrome (ACS) through 3 to 5 years of follow-up.
For patients with ACS, some prognostic indicators can be used to predict new onset AF.
The Improving Care for Cardiovascular Disease in China-ACS (CCC-ACS) program was launched in 2014 by a collaborative initiative of the American Heart Association and Chinese Society of Cardiology. We enrolled 866 patients with ACS in a telephone follow-up program. We inquired about each patient's general health and invited each patient to our hospital for further consultation. We also performed ambulatory electrocardiography and other relevant examinations.
A total of 743 ACS patients were included in the study. After 3 to 5 years, 50 (0.67%) patients developed AF. In multivariable Cox models adjusting for AF risk factors in ACS patients, we found that NT-proBNP [hazard ratio (HR) 2.625, 1.654-4.166, P < .05], creatine kinase-MB (CK-MB) (HR 4.279, 1.887-9.703, P < .05), and left ventricular ejection fraction (LVEF) (HR 0.01, 0.001-0.352, P < .05) were significantly associated with AF receiver operating characteristic (ROC) curves were used to determine a cutoff level for AF screening. NT-proBNP using a cutoff of 1705 ng/L resulted in a sensitivity of 58% and a specificity of 89.8%. CK-MB using a cutoff of 142.5 ng/L resulted in a sensitivity of 73.3% and a specificity of 58.3%.
For patients with ACS, NT-proBNP, CK-MB, and LVEF have a considerable prognostic value for predicting whether AF would be detected during follow-up.
本研究旨在通过 3 至 5 年的随访，评估急性冠状动脉综合征（ACS）患者新发心房颤动（AF）的预后指标。
对于 ACS 患者，一些预后指标可用于预测新发 AF。
美国心脏协会与中华医学会心血管病学分会于 2014 年联合发起“改善中国心血管病防治策略（CCC-ACS）”项目。我们纳入了 866 例 ACS 患者进行电话随访。我们询问了每位患者的一般健康状况，并邀请每位患者到我院进一步就诊。我们还进行了动态心电图和其他相关检查。
共有 743 例 ACS 患者纳入本研究。随访 3 至 5 年后，有 50 例（0.67%）患者发生 AF。在多变量 Cox 模型中，我们调整了 ACS 患者的 AF 危险因素，发现 NT-proBNP[风险比（HR）2.625，1.654-4.166，P<.05]、肌酸激酶同工酶-MB（CK-MB）（HR 4.279，1.887-9.703，P<.05）和左心室射血分数（LVEF）（HR 0.01，0.001-0.352，P<.05）与 AF 显著相关。ROC 曲线用于确定 AF 的筛查切点。NT-proBNP 使用 1705ng/L 的截断值时，其灵敏度为 58%，特异性为 89.8%。CK-MB 使用 142.5ng/L 的截断值时，其灵敏度为 73.3%，特异性为 58.3%。
对于 ACS 患者，NT-proBNP、CK-MB 和 LVEF 对预测 AF 在随访期间是否发生具有重要的预后价值。
