住院冠心病合并高血压患者心房颤动的患病率及临床特征：一项 2008 年至 2018 年的横断面研究。

Prevalence and clinical characteristics of atrial fibrillation in hospitalized patients with coronary artery disease and hypertension: a cross-sectional study from 2008 to 2018.

机构信息

Department of Cardiology, The Sixth Medical Center of Chinese People's Liberation Army General Hospital, Beijing 100048, China.

The School of Medicine, Nankai University, Tianjin 300071, China.

出版信息

Chin Med J (Engl). 2023 Mar 5;136(5):588-595. doi: 10.1097/CM9.0000000000002471.

DOI:10.1097/CM9.0000000000002471

PMID:36914935

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10106139/

Abstract

BACKGROUND

The clinical characteristics of patients with the comorbidities of hypertension and coronary artery disease (HT-CAD) and atrial fibrillation (AF) are largely unknown. This study aimed to investigate the prevalence of AF in patients with HT-CAD and clinical characteristics of patients with both HT-CAD and AF.

METHODS

This cross-sectional study was conducted in Chinese People's Liberation Army General Hospital in Beijing, China, and included 20,747 inpatients with HT-CAD with or without AF from August 2008 to July 2018. We examined the overall prevalence, clinical characteristics, comorbidity profiles, treatment patterns, and blood pressure (BP) control of patients with both HT-CAD and AF. Multivariate logistic regression was used to investigate the associations of cardiovascular risk factors with AF in patients with HT-CAD.

RESULTS

The overall prevalence of AF in patients with HT-CAD was 4.87% (1011/20,747), and this increased with age; to be specific, the prevalence in women and men increased from 0.78% (2/255) and 1.02% (26/2561) at the age of <50 years to 8.73% (193/2210) and 10.28% (298/2900) at the age of ≥70 years, respectively. HT-CAD patients who had AF had a higher prevalence of cardiovascular-related comorbidities than those without AF. Multivariate logistic regression showed that age, gender (male), body mass index, heart failure, and chronic kidney disease were independently associated with the risk of AF in patients with HT-CAD. For those with both HT-CAD and AF, 73.49% (743/1011) had a CHA 2 DS 2 -VASc score of ≥4, and only about half of them had the BP controlled at <140/90 mmHg, which indicated a high risk of thromboembolism and stroke. The use of oral anticoagulation increased during the study period (10.00% [20/200] in 2008 to 2011 vs. 30.06% [159/529] in 2015 to 2018, P < 0.01), but remained at a relatively low level.

CONCLUSIONS

AF is highly prevalent among patients with HT-CAD. Patients with both HT-CAD and AF have a higher prevalence of cardiovascular-related comorbidities, lower BP control rate, and lower use of oral anticoagulation.

摘要

背景

高血压合并冠状动脉疾病（HT-CAD）和心房颤动（AF）患者的临床特征在很大程度上尚不清楚。本研究旨在调查 HT-CAD 患者中 AF 的患病率以及同时患有 HT-CAD 和 AF 的患者的临床特征。

方法

本横断面研究在北京的中国人民解放军总医院进行，纳入了 2008 年 8 月至 2018 年 7 月期间 20747 例 HT-CAD 住院患者，其中包括合并或不合并 AF 的患者。我们检查了同时患有 HT-CAD 和 AF 的患者的总体患病率、临床特征、合并症谱、治疗模式和血压（BP）控制情况。多变量逻辑回归用于研究 HT-CAD 患者心血管危险因素与 AF 的关系。

结果

HT-CAD 患者中 AF 的总体患病率为 4.87%（1011/20747），且随年龄增长而增加；具体而言，女性和男性中，年龄＜50 岁的患病率为 0.78%（2/255）和 1.02%（26/2561），年龄≥70 岁的患病率分别为 8.73%（193/2210）和 10.28%（298/2900）。与无 AF 的 HT-CAD 患者相比，同时患有 HT-CAD 和 AF 的患者更易发生心血管相关合并症。多变量逻辑回归显示，年龄、性别（男性）、体重指数、心力衰竭和慢性肾脏病与 HT-CAD 患者发生 AF 的风险独立相关。对于同时患有 HT-CAD 和 AF 的患者，73.49%（743/1011）的 CHA 2 DS 2 -VASc 评分为≥4，且仅有约一半患者的 BP 控制在＜140/90mmHg，这表明存在较高的血栓栓塞和卒中风险。在研究期间，口服抗凝药物的使用率有所增加（2008 年至 2011 年为 10.00%[20/200]，2015 年至 2018 年为 30.06%[159/529]，P<0.01），但仍处于较低水平。