Ukenenye Emmanuel, Oshiba Tolulope, Okoronkwo Emeka, Obomanu Elvis, Asaolu Gideon, Urhi Alexsandra, Olateju Iyanu Victoria, Onyemarim Henry, Uzzi Consolata, Alugba Gabriel, Oladunjoye Adeolu Funso, Oladunjoye Olubunmi
One Brooklyn Health-Brookdale University Hospital and Medical Center Medical, Brooklyn, NY, United States.
Medical Council of Jamaica, University of the West Indies, 18 West Rd, Kingston, 2762+3VM, Jamaica.
Heliyon. 2023 Mar 21;9(4):e14725. doi: 10.1016/j.heliyon.2023.e14725. eCollection 2023 Apr.
Autonomic dysfunction in Parkinson's disease (PD) includes cardiovascular dysregulations which may manifest as an increased risk of atrial fibrillation (AF). However, data on the impact of PD in AF patients is lacking. Our study aimed to investigate the differences in in-hospital mortality of patients admitted for AF with underlying PD versus those without PD.
We examined the National Inpatient Sample (NIS) database from 2016 to 2019 for hospitalizations of AF as a principal diagnosis with and without PD as a secondary diagnosis. The primary outcome was inpatient mortality. The secondary endpoints were ventricular tachycardia (VT), ventricular fibrillation (VF), acute heart failure (AHF), cardiogenic shock (CS), cardiac arrest (CA), total hospital charge (THC), and length of stay (LOS).
Of 1,861,859 A F hospitalizations, 0.01% (19,490) had coexisting PD. Cohorts of PD vs No-PD had a mean age of 78.1 years [CI 77.9-78.4] vs 70.5 years [CI 70.4-70.5]; male (56.3% vs 50.7%), female (43.7% vs 49.3%). The PD category had similar in-hospital mortality with the no-PD category (OR = 1.18 [0.89-1.57] P = 0.240). The PD group had a lesser incidence of AHF (OR = 0.79 [0.72-0.86] P < 0.001) and VT (OR = 0.77 [0.62-0.95] P = 0.015).
Co-existing PD in patients admitted for AF was not associated with increased in-hospital mortality; however, there were lower odds of AHF and VT. The diminished arrhythmogenic neurohormonal axis may explain these cardiovascular benefits. Notwithstanding, to better understand the outcomes of AF in patients with PD, additional studies are required.
帕金森病（PD）中的自主神经功能障碍包括心血管调节异常，这可能表现为心房颤动（AF）风险增加。然而，关于PD对AF患者影响的数据尚缺。我们的研究旨在调查合并PD的AF患者与未合并PD的AF患者住院死亡率的差异。
我们查阅了2016年至2019年的全国住院患者样本（NIS）数据库，以查找以AF作为主要诊断且有或无PD作为次要诊断的住院病例。主要结局是住院死亡率。次要终点包括室性心动过速（VT）、室颤（VF）、急性心力衰竭（AHF）、心源性休克（CS）、心脏骤停（CA）、总住院费用（THC）和住院时长（LOS）。
在1,861,859例AF住院病例中，0.01%（19,490例）合并PD。PD组与非PD组的平均年龄分别为78.1岁[CI 77.9 - 78.4]和70.5岁[CI 70.4 - 70.5]；男性比例分别为56.3%和50.7%，女性比例分别为43.7%和49.3%。PD组与非PD组的住院死亡率相似（OR = 1.18 [0.89 - 1.57]，P = 0.240）。PD组AHF（OR = 0.79 [0.72 - 0.86]，P < 0.001）和VT（OR = 0.77 [0.62 - 0.95]，P = 0.015）的发生率较低。
合并PD的AF住院患者与住院死亡率增加无关；然而，AHF和VT的发生几率较低。心律失常性神经激素轴减弱可能解释了这些心血管方面的益处。尽管如此，为了更好地了解PD患者AF的结局，还需要进一步的研究。
