肾上腺功能不全与心房颤动、心房扑动和阵发性室上性心动过速患者心血管结局的关系。
Relationships between adrenal insufficiency and cardiovascular outcomes in patients with atrial fibrillation, atrial flutter and paroxysmal supraventricular tachycardia.
机构信息
Department of Internal Medicine, Hennepin Healthcare, Minneapolis, MN, USA.
Department of Internal Medicine, Hennepin Healthcare, Minneapolis, MN, USA.
出版信息
Curr Probl Cardiol. 2024 Aug;49(8):102641. doi: 10.1016/j.cpcardiol.2024.102641. Epub 2024 May 15.
BACKGROUND
Patients with Adrenal Insufficiency (AI) face elevated cardiovascular risks, but little remains known about arrhythmia outcomes in this context.
METHOD
Analyzing the 2016-2019 Nationwide Inpatient Sample, we identified cases of Atrial Fibrillation, Atrial Flutter, and paroxysmal supraventricular tachycardia (PSVT) with a secondary diagnosis of AI. Mortality was the primary outcome while vasopressors and/or mechanical ventilation use, length of stay (LOS), and total hospitalization charges (THC) constituted secondary outcomes. Multivariate linear and logistic regression models were used to adjust for confounders.
RESULTS
Among patients with Atrial Fibrillation, Atrial Flutter, and PSVT (N=1,556,769), 0.2% had AI. AI was associated with higher mortality (adjusted OR [aOR] 2.29, p=0.001), vasopressor and/or mechanical ventilation use (aOR 2.54, p<0.001), THC ($62,347 vs. $41,627, p<0.001) and longer LOS (4.4 vs. 3.2 days, p<0.001) compared to no AI.
CONCLUSION
AI was associated with higher adverse outcomes in cases of Atrial Fibrillation, Atrial Flutter, and PSVT.
背景
肾上腺功能不全 (AI) 患者面临更高的心血管风险，但在这方面，关于心律失常结局的了解甚少。
方法
我们分析了 2016 年至 2019 年的全国住院患者样本，确定了伴有 AI 次要诊断的心房颤动、心房扑动和阵发性室上性心动过速 (PSVT) 病例。死亡率是主要结局，而血管加压素和/或机械通气的使用、住院时间 (LOS) 和总住院费用 (THC) 是次要结局。使用多变量线性和逻辑回归模型来调整混杂因素。
结果
在患有心房颤动、心房扑动和 PSVT 的患者中（N=1,556,769），有 0.2%患有 AI。AI 与更高的死亡率相关（调整后的比值比[aOR] 2.29，p=0.001），血管加压素和/或机械通气的使用（aOR 2.54，p<0.001）、THC（$62,347 与$41,627，p<0.001）和 LOS 更长（4.4 天与 3.2 天，p<0.001）与无 AI 相比。
结论
在心房颤动、心房扑动和 PSVT 的情况下，AI 与更差的不良结局相关。
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