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急性心肌梗死合并心房颤动患者:贫血与住院出血、卒中及其他死亡原因风险的相关性。

Patients with acute myocardial infarction and atrial fibrillation: association of anaemia with risk of in-hospital bleeding, stroke and other death causes.

机构信息

Emergency Department of China-Japan Friendship Hospital, Chaoyang District, Beijing, China.

Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

出版信息

Biomarkers. 2021 Mar;26(2):163-167. doi: 10.1080/1354750X.2020.1871513. Epub 2021 Jan 19.

Abstract

PURPOSES

To explore the association of anaemia with risk of outcomes of in-hospital patients with acute myocardial infarction (AMI) and atrial fibrillation (AF).

METHODS

Patients with AF and AMI at their first hospitalizations in three hospitals (Beijing Tongren Hospital, Beijing Friendship Hospital, Capital Medical University and China-Japan Friendship Hospital) were retrospectively reviewed and divided into two groups (with vs. without anaemia) according to haemoglobin within one day before or after admission.

RESULTS

864 patients with AF and AMI (mean age:74.22 years; 39.9% female) were included in the current study. Patients with anaemia had increased risk of any bleeding (adjusted OR: 2.29, 95% CI: 1.43-3.68,  = 0.001), minor bleeding (adjusted OR: 2.37, 95% CI:1.40-4.01,  = 0.001), gastrointestinal bleeding (adjusted OR: 2.53, 95% CI:1.51-4.25,  < 0.001) and other death causes (adjusted OR: 1.71, 95% CI: 1.07-2.72,  = 0.02) compared to those without anaemia according to logistic regression. However, there was no difference in the risk of stroke or/and systematic embolism (SE) between patients with and without anaemia.

CONCLUSIONS

In the Chinese in-hospital AMI and AF cohort, anaemia was shown to be associated with increased risk of any bleeding, minor bleeding, gastrointestinal bleeding and other death causes, but not the risk of stroke or/and SE.

摘要

目的

探讨贫血与急性心肌梗死(AMI)和心房颤动(AF)住院患者结局风险的关系。

方法

回顾性分析三所医院(北京同仁医院、北京友谊医院、首都医科大学和中日友好医院)首次住院的 AF 和 AMI 患者,根据入院前一天或后一天的血红蛋白水平将患者分为两组(贫血组和非贫血组)。

结果

本研究共纳入 864 例 AF 和 AMI 患者(平均年龄:74.22 岁;女性占 39.9%)。贫血患者发生任何出血(校正 OR:2.29,95%CI:1.43-3.68, = 0.001)、轻微出血(校正 OR:2.37,95%CI:1.40-4.01, = 0.001)、胃肠道出血(校正 OR:2.53,95%CI:1.51-4.25, < 0.001)和其他死亡原因(校正 OR:1.71,95%CI:1.07-2.72, = 0.02)的风险均高于非贫血患者,这是通过逻辑回归得出的。然而,贫血患者与非贫血患者发生中风或/和系统性栓塞(SE)的风险并无差异。

结论

在中国住院的 AMI 和 AF 患者中,贫血与任何出血、轻微出血、胃肠道出血和其他死亡原因的风险增加相关,但与中风或/和 SE 的风险无关。

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