Kuźma Łukasz, Tomaszuk-Kazberuk Anna, Kurasz Anna, Dobrzycki Sławomir, Koziński Marek, Sobkowicz Bożena, Lip Gregory Y H
Department of Invasive Cardiology, Medical University of Białystok, 15-089 Białystok, Poland.
Department of Cardiology, Medical University of Białystok, 15-089 Białystok, Poland.
J Clin Med. 2021 Oct 26;10(21):4949. doi: 10.3390/jcm10214949.
Over the next decades, the prevalence of atrial fibrillation (AF) is estimated to double. Our aim was to investigate the causes of the long-term mortality in relation to the diagnosis of atrial fibrillation (AF) and chronic coronary syndrome (CCS). The analysed population consisted of 7367 consecutive patients referred for elective coronary angiography enrolled in a large single-centre retrospective registry, out of whom 1484 had AF and 2881 were diagnosed with obstructive CCS. During follow-up (median = 2029 days), 1201 patients died. The highest all-cause death was seen in AF(+)/CCS(+) [194/527; 36.8%], followed by AF(+)/CCS(-) [210/957; 21.9%], AF(-)/CCS(+) [(459/2354; 19.5%)] subgroups. AF ([HR] = 1.48, 95%CI, 1.09-2.01; HR = 1.34, 95%CI, 1.07-1.68) and obstructive CCS (HR = 1.90, 95%CI, 1.56-2.31; HR = 2.27, 95%CI, 1.94-2.65) together with age, male gender, heart failure, obstructive pulmonary disease, diabetes were predictors of both all-cause and CV mortality. The main findings are as follow among patients referred for elective coronary angiography, both AF and obstructive CCS are strong and independent predictors of the long-term mortality. Mortality of AF without CCS was at least as high as non-AF patients with CCS. CV deaths were more frequent than non-CV deaths in AF patients with CCS compared to those with either AF or CCS alone.
在接下来的几十年里，房颤（AF）的患病率预计将翻倍。我们的目的是调查与房颤（AF）和慢性冠状动脉综合征（CCS）诊断相关的长期死亡率原因。分析的人群包括7367例连续接受择期冠状动脉造影的患者，这些患者被纳入一个大型单中心回顾性登记研究，其中1484例患有房颤，2881例被诊断为阻塞性CCS。在随访期间（中位数 = 2029天），1201例患者死亡。全因死亡率最高的是AF(+)/CCS(+)组[194/527；36.8%]，其次是AF(+)/CCS(-)组[210/957；21.9%]、AF(-)/CCS(+)组[(459/2354；19.5%)]。房颤（[HR]=1.48，95%CI，1.09 - 2.01；HR = 1.34，95%CI，1.07 - 1.68）和阻塞性CCS（HR = 1.90，95%CI，1.56 - 2.31；HR = 2.27，95%CI，1.94 - 2.65）以及年龄、男性性别、心力衰竭、阻塞性肺病、糖尿病是全因死亡率和心血管死亡率的预测因素。在接受择期冠状动脉造影的患者中，主要发现如下：房颤和阻塞性CCS都是长期死亡率的强有力独立预测因素。无CCS的房颤患者死亡率至少与有CCS的非房颤患者一样高。与单独患有房颤或CCS的患者相比，患有CCS的房颤患者心血管死亡比非心血管死亡更频繁。
