Hang Fei, Chen Jieruo, Wang Zefeng, Yan Jiafu, Wu Yongquan
Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Front Cardiovasc Med. 2022 May 6;9:881946. doi: 10.3389/fcvm.2022.881946. eCollection 2022.
Frailty was found to be common in patients with atrial fibrillation/flutter (AF), but there was still a lack of evidence regarding the relationship between frailty and new-onset AF.
We performed a analysis of data from the Systolic Blood Pressure Intervention Trial (SPRINT). In addition, we evaluated the relationship between baseline frailty status and new-onset AF in older adult patients with hypertension.
In total, 7,316 participants were included in our analysis, and a total of 115 new-onset AF occurred during an average of 3.54 years of follow-up. Using SPRINT frailty index criteria, 1,535 fit, 4,041 less fit, and 1,740 frailty were enrolled. Compared with other groups, the incidence of new-onset AF in the frailty group was significantly higher. We constructed three Cox models to assess the relationship between the frailty status (fit group as reference) and new-onset AF. Participants with frailty had a significantly higher risk of new-onset AF compared with the fit group in all the models we used. We combined the fit group and the less fit group into a no frailty group to assess the impact of frailty on new-onset AF in various subgroups. After full adjustment (Model 3), frailty remained associated with the increased risk of new-onset AF compared with the no frailty group [hazard ratio [] = 2.09, :(1.41, 3.09), < 0.001]. Additionally, we examined the frailty index as continuous variable to assess the relationship between the frailty index and new-onset AF. The smooth curve showed that log HR appeared to increase linearly. And there was a significant interaction between baseline systolic blood pressure (SBP) categories and frailty on the risk of new-onset AF ( = 0.030).
This study found baseline frailty status was a strong independent risk factor for new-onset AF among older adult patients with hypertension. Screening for frailty should be considered in older adult patients with hypertension to prevent new-onset AF.
研究发现衰弱在心房颤动/心房扑动（AF）患者中很常见，但关于衰弱与新发房颤之间的关系仍缺乏证据。
我们对收缩压干预试验（SPRINT）的数据进行了分析。此外，我们评估了老年高血压患者基线衰弱状态与新发房颤之间的关系。
我们的分析共纳入7316名参与者，在平均3.54年的随访期间共发生115例新发房颤。根据SPRINT衰弱指数标准，纳入1535名健康者、4041名较不健康者和1740名衰弱者。与其他组相比，衰弱组新发房颤的发生率显著更高。我们构建了三个Cox模型来评估衰弱状态（以健康组为参照）与新发房颤之间的关系。在我们使用的所有模型中，与健康组相比，衰弱参与者发生新发房颤的风险显著更高。我们将健康组和较不健康组合并为非衰弱组，以评估衰弱对各亚组新发房颤的影响。经过全面调整（模型3），与非衰弱组相比，衰弱仍与新发房颤风险增加相关[风险比[] = 2.09，95%置信区间：(1.41, 3.09)，P < 0.001]。此外，我们将衰弱指数作为连续变量进行检验，以评估衰弱指数与新发房颤之间的关系。平滑曲线显示，对数风险比似乎呈线性增加。并且基线收缩压（SBP）类别与衰弱在新发房颤风险上存在显著交互作用（P = 0.030）。
本研究发现，基线衰弱状态是老年高血压患者新发房颤的一个强有力的独立危险因素。对于老年高血压患者，应考虑进行衰弱筛查以预防新发房颤。
