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人体测量因素对心房颤动患者结局的影响:来自欧洲心脏病学会(ESC)-欧洲心律协会(EHRA)欧洲心房颤动观察性研究计划(EORP-AF)一般长期注册研究的 10220 例患者分析。

Impact of anthropometric factors on outcomes in atrial fibrillation patients: analysis on 10 220 patients from the European Society of Cardiology (ESC)-European Heart Rhythm Association (EHRA) EurObservational Research Programme on Atrial Fibrillation (EORP-AF) general long-term registry.

机构信息

Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy.

Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.

出版信息

Eur J Prev Cardiol. 2022 Nov 8;29(15):1967-1981. doi: 10.1093/eurjpc/zwac115.

DOI:10.1093/eurjpc/zwac115
PMID:35671129
Abstract

AIM

To investigate the association of anthropometric parameters [height, weight, body mass index (BMI), body surface area (BSA), and lean body mass (LBM)] with outcomes in atrial fibrillation (AF).

METHODS AND RESULTS

Ten-thousand two-hundred twenty patients were enrolled [40.3% females, median age 70 (62-77) years, followed for 728 (interquartile range 653-745) days]. Sex-specific tertiles were considered for the five anthropometric variables. At the end of follow-up, survival free from all-cause death was worse in the lowest tertiles for all the anthropometric variables analyzed. On multivariable Cox regression analysis, an independent association with all-cause death was found for the lowest vs. middle tertile when body weight (hazard ratio [HR] 1.66, 95%CI 1.23-2.23), BMI (HR 1.65, 95%CI 1.23-2.21), and BSA (HR 1.49, 95%CI 1.11-2.01) were analysed in female sex, as well as for body weight in male patients (HR 1.61, 95%CI 1.25-2.07). Conversely, the risk of MACE was lower for the highest tertile (vs. middle tertile) of BSA and LBM in males and for the highest tertile of weight and BSA in female patients. A higher occurrence of haemorrhagic events was found for female patients in the lowest tertile of height [odds ratio (OR) 1.90, 95%CI 1.23-2.94] and LBM (OR 2.13, 95%CI 1.40-3.26).

CONCLUSIONS

In AF patients height, weight, BMI, BSA, and LBM were associated with clinical outcomes, with all-cause death being higher for patients presenting lower values of these variables, i.e. in the lowest tertiles of distribution. The anthropometric variables independently associated with other outcomes were also different between male and female subjects.

摘要

目的

探讨人体测量参数(身高、体重、体重指数(BMI)、体表面积(BSA)和瘦体重(LBM))与心房颤动(AF)结局的相关性。

方法和结果

共纳入 12200 例患者[40.3%为女性,中位年龄 70(62-77)岁,随访 728(四分位距 653-745)天]。对于五个人体测量变量,考虑了性别特异性三分位数。在随访结束时,所有分析的人体测量变量中,最低三分位数的全因死亡无生存获益。多变量 Cox 回归分析显示,当体重(风险比 [HR] 1.66,95%CI 1.23-2.23)、BMI(HR 1.65,95%CI 1.23-2.21)和 BSA(HR 1.49,95%CI 1.11-2.01)时,最低与中间三分位数相比,在女性中与全因死亡存在独立相关性,以及在男性患者中体重(HR 1.61,95%CI 1.25-2.07)。相反,对于男性患者,BSA 和 LBM 的最高三分位数(与中间三分位数相比)以及女性患者的体重和 BSA 的最高三分位数,MACE 的风险较低。女性患者身高(比值比 [OR] 1.90,95%CI 1.23-2.94)和 LBM(OR 2.13,95%CI 1.40-3.26)最低三分位数发生出血事件的几率更高。

结论

在 AF 患者中,身高、体重、BMI、BSA 和 LBM 与临床结局相关,这些变量值较低的患者(即分布最低三分位数的患者)的全因死亡率更高。与其他结局相关的人体测量变量也因男性和女性患者而异。

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