Li Ming, Zheng Chongzhou, Chen Chunmei, Zheng Xifeng, He Zhongkai
Department of Cardiology, Affiliated Hospital of Guangdong Medical University, 524001 Zhanjiang, Guangdong, China.
Rev Cardiovasc Med. 2024 Jan 29;25(2):42. doi: 10.31083/j.rcm2502042. eCollection 2024 Feb.
To identify the decrease in estimated glomerular filtration rate (eGFR) as an independent risk factor associated with ventricular tachyarrhythmias (VTA).
This retrospective file review collected information from patients diagnosed with acute myocardial infarction (AMI), with and without VTA, from January 2017 to December 2019. We first applied the chi-square test to assess 12 risk factors and one outcome variable (incident rate of VTA). Next, all the 12 risk factors were further adjusted using the propensity score matching (PSM) method to simulate the dataset as a randomized controlled cohort, which can reduce the defects derived from confounding factors and the imbalance in baseline characteristics. To investigate the relationship between eGFR and VTA, univariate logistic regression analysis was applied to the cohort before and after PSM analysis.
A total of 503 patients diagnosed as AMI were included in the study. There were eight of twelve risk factors in baseline characteristics with a -value 0.05, as determined by the chi-square test before PSM matching. The result of PSM analysis indicated that 86 of 91 patients with decreased eGFR were matched, and all the risk factors were not significantly different (-value 0.05). The incident rates of VTA in the two groups were still significantly different (-value 0.001) according to the Pearson chi-square test in the cohort after PSM analysis. The results of univariate (eGFR) logistic regression indicated that the odds ratio of the cohort was 6.442 (95% confidence interval = 3.770-11.05) and 3.654 (95% confidence interval = 1.764-7.993) before and after PSM analysis respectively.
The decrease in eGFR ( 60 mL/min/1.73 ) has been demonstrated as an independent risk factor for VTA after AMI.
将估算肾小球滤过率(eGFR)降低确定为与室性快速性心律失常(VTA)相关的独立危险因素。
本回顾性病历审查收集了2017年1月至2019年12月期间诊断为急性心肌梗死(AMI)且伴有或不伴有VTA的患者的信息。我们首先应用卡方检验来评估12个危险因素和一个结局变量(VTA的发生率)。接下来,使用倾向评分匹配(PSM)方法对所有12个危险因素进行进一步调整,以模拟数据集为随机对照队列,这可以减少混杂因素和基线特征不平衡所带来的缺陷。为了研究eGFR与VTA之间的关系,在PSM分析前后对该队列进行单因素逻辑回归分析。
本研究共纳入503例诊断为AMI的患者。在PSM匹配前通过卡方检验确定,基线特征中的12个危险因素中有8个p值<0.05。PSM分析结果表明,91例eGFR降低的患者中有86例匹配成功,所有危险因素均无显著差异(p值>0.05)。根据PSM分析后队列中的Pearson卡方检验,两组中VTA的发生率仍有显著差异(p值<0.001)。单因素(eGFR)逻辑回归结果表明,PSM分析前后队列的优势比分别为6.442(95%置信区间=3.770-11.05)和3.654(95%置信区间=1.764-7.993)。
eGFR降低(<60 mL/min/1.73 m²)已被证明是AMI后VTA的独立危险因素。