Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom.
Department of Cardiology, Hospital Clínico Universitario Virgen de La Arrixaca, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBERCV, Murcia, Spain.
Intern Emerg Med. 2023 Mar;18(2):423-428. doi: 10.1007/s11739-022-03184-6. Epub 2023 Jan 14.
An association with aortic aneurysm has been reported among patients with atrial fibrillation (AF). The aims of this study were to investigate the prevalence of thoracic aorta aneurysm (TAA) among patients with AF and to assess whether the co-presence of TAA is associated with a higher risk of adverse clinical outcomes.
Using TriNetX, a global federated health research network of anonymised electronic medical records, all adult patients with AF, were categorised into two groups based on the presence of AF and TAA or AF alone. Between 1 January 2017 and 1 January 2019, 874,212 people aged ≥ 18 years with AF were identified. Of these 17,806 (2.04%) had a TAA. After propensity score matching (PSM), 17,805 patients were included in each of the two cohorts. During the 3 years of follow-up, 3079 (17.3%) AF patients with TAA and 2772 (15.6%) patients with AF alone, developed an ischemic stroke or transient ischemic attack (TIA). The risk of ischemic stroke/TIA was significantly higher in patients with AF and TAA (HR 1.09, 95% CI 1.04-1.15; log-rank p value < 0.001) The risk of major bleeding was higher in patients with AF and TAA (OR 1.07, 95% CI 1.01-1.14), but not significant in time-dependent analysis (HR 1.04, 95% CI 0.98-1.10; log-rank p value = 0.187), CONCLUSION: This retrospective analysis reports a clinical concomitance of the two medical conditions, and shows in a PSM analysis an increased risk of ischemic events in patients affected by TAA and AF compared to AF alone.
已有研究报道，心房颤动（AF）患者与胸主动脉瘤（TAA）相关。本研究旨在调查 AF 患者 TAA 的患病率，并评估 TAA 的共存是否与不良临床结局风险增加相关。
利用 TriNetX，一个匿名电子病历的全球联邦健康研究网络，根据 AF 和 TAA 或 AF 单独存在，将所有成年 AF 患者分为两组。在 2017 年 1 月 1 日至 2019 年 1 月 1 日期间，确定了 874212 名年龄≥18 岁的 AF 患者。其中 17806 例（2.04%）存在 TAA。经过倾向评分匹配（PSM）后，每组纳入 17805 例患者。在 3 年的随访期间，3079 例（17.3%）AF 合并 TAA 患者和 2772 例（15.6%）AF 患者发生缺血性卒中和短暂性脑缺血发作（TIA）。AF 合并 TAA 患者发生缺血性卒中和 TIA 的风险显著高于单纯 AF 患者（HR 1.09，95%CI 1.04-1.15；log-rank p 值<0.001）。AF 合并 TAA 患者大出血风险较高（OR 1.07，95%CI 1.01-1.14），但在时间依赖性分析中无统计学意义（HR 1.04，95%CI 0.98-1.10；log-rank p 值=0.187）。
本回顾性分析报告了这两种医学病症的临床并存性，并在 PSM 分析中显示，与单纯 AF 相比，TAA 合并 AF 患者发生缺血性事件的风险增加。
