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心肌梗死患者新发心房颤动的发生率、临床预测因素及临床效果:一项回顾性队列研究。

Incidence, clinical predictors, and clinical effect of new-onset atrial fibrillation in myocardial infarction patients: A retrospective cohort study.

机构信息

From the Department of Cardiac Sciences (Elshaer, Alsaleh); from the College of Medicine (Elshaer, Alsaeed, Alfehaid, Alshahrani, Alduhayyim), King Saud University Medical City, King Saud University, Riyadh, Kingdom of Saudi Arabia; and from the Department of Cardiology (Elshaer), National Heart Institute, Cairo, Egypt.

出版信息

Saudi Med J. 2022 Aug;43(8):933-940. doi: 10.15537/smj.2022.43.8.20220349.

Abstract

OBJECTIVES

To calculate the incidence of new-onset atrial fibrillation (NOAF) in myocardial infarction (MI) patients and examine associated predictors and clinical outcomes of NOAF patients.

METHODS

A retrospective cohort study was used to carry out this study. All MI patients admitted to King Khaled University Hospital, Riyadh, Saudi Arabia, between January 2015 to 2020 were eligible for inclusion. The study excluded those with a previous diagnosis of atrial fibrillation and patients who died at presentation.

RESULTS

A total of 281 patients were analyzed with a mean age of 58.7±12.7. Incidence of NOAF was 7.8%. Significant predictors identified by multivariate logistic regression analysis included older age (=0.004), history of MI (=0.012), and undergoing coronary artery bypass graft surgery (CABG) as treatment (=0.016). New-onset atrial fibrillation was associated with higher odds of major adverse cardiovascular event (=0.039), ventricular tachycardia (=0.001), and mortality (=0.031).

CONCLUSION

New-onset atrial fibrillation is a relatively common complication of MI, and in our study, it was associated with higher odds of further complications including death. Therefore, identification of MI patients at risk of developing NOAF is crucial. Our study suggests that older age, a previous history of MI, and undergoing CABG are significant predictors of NOAF development.

摘要

目的

计算心肌梗死(MI)患者中新发心房颤动(NOAF)的发生率,并探讨 NOAF 患者的相关预测因素和临床结局。

方法

本研究采用回顾性队列研究。沙特阿拉伯利雅得的 King Khaled 大学医院收治的所有 MI 患者均符合纳入标准。本研究排除了有先前心房颤动诊断和在就诊时死亡的患者。

结果

共分析了 281 例患者,平均年龄为 58.7±12.7 岁。NOAF 的发生率为 7.8%。多变量逻辑回归分析确定的显著预测因素包括年龄较大(=0.004)、MI 病史(=0.012)和接受冠状动脉旁路移植术(CABG)作为治疗(=0.016)。新发心房颤动与主要不良心血管事件(=0.039)、室性心动过速(=0.001)和死亡率(=0.031)的发生几率增加相关。

结论

新发心房颤动是 MI 的一种常见并发症,在本研究中,它与更高的进一步并发症(包括死亡)几率相关。因此,识别有发生 NOAF 风险的 MI 患者至关重要。本研究表明,年龄较大、有先前的 MI 病史和接受 CABG 是发生 NOAF 的显著预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b4b/9749668/7b1eb63a4189/smj-43-8-933_page_2_1.jpg

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