Liu Peng, Lv Tingting, Liu Yuanwei, Zhang Xiaofei, She Fei, He Rong, Li Dan, Liu Lianfeng, Zhang Ping
Department of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, People's Republic of China.
Department of Cardiology, Ordos Central Hospital, Ordos School of Clinical Medicine, Inner Mongolia Medical University, Inner Mongolia, People's Republic of China.
Risk Manag Healthc Policy. 2024 Oct 29;17:2587-2598. doi: 10.2147/RMHP.S482876. eCollection 2024.
Atrial fibrillation (AF) is known to increase the risk of thromboembolic events and major adverse cardiovascular events (MACE). The impact of paroxysmal atrial tachycardia (PAT) on these risks remains unclear.
This retrospective cohort study was conducted involving 889 patients diagnosed with PAT and 1106 control patients without PAT, all of whom underwent their initial 24-hour ECG monitoring between 2015 to 2020. Kaplan-Meier survival analysis and Cox regression analysis were used to evaluate the association between PAT and the study endpoints, including thromboembolic events and MACE.
Over a mean follow-up period of 50.3 months, the incidence of thromboembolic events and MACE was significantly higher in the PAT group compared to the control group (6.5% vs 1.7% and 19.1% vs 9.9%, respectively). After adjusting for common risk factors and baseline imbalances, the PAT group exhibited a significantly elevated risk of thromboembolic events (hazard ratio [HR] 3.782, 95% confidence interval [CI] 2.212-6.467; <0.001) and MACE (HR 1.795, 95% CI 1.398-2.305; <0.001). However, the frequency of PAT episodes, heart rate, and maximum heart rate were not significantly associated with these outcomes. Within the PAT group, a history of stroke, transient ischemic attack, and chronic renal failure were identified as independent risk factors for thromboembolic events, while hypertension, coronary heart disease, heart failure, and chronic renal failure were independently associated with MACE.
PAT, as detected by 24-hour dynamic ECG, is associated with an increased risk of thromboembolic events and MACE.
已知心房颤动（AF）会增加血栓栓塞事件和主要不良心血管事件（MACE）的风险。阵发性房性心动过速（PAT）对这些风险的影响尚不清楚。
本回顾性队列研究纳入了889例诊断为PAT的患者和1106例无PAT的对照患者，所有患者均在2015年至2020年间接受了首次24小时心电图监测。采用Kaplan-Meier生存分析和Cox回归分析来评估PAT与研究终点之间的关联，研究终点包括血栓栓塞事件和MACE。
在平均50.3个月的随访期内，PAT组的血栓栓塞事件和MACE发生率显著高于对照组（分别为6.5%对1.7%和19.1%对9.9%）。在调整常见危险因素和基线不平衡因素后，PAT组发生血栓栓塞事件的风险显著升高（风险比[HR]3.782，95%置信区间[CI]2.212 - 6.467；P<0.001）以及MACE的风险（HR 1.795，95%CI 1.398 - 2.305；P<0.001）。然而，PAT发作频率、心率和最大心率与这些结局无显著关联。在PAT组中，卒中病史、短暂性脑缺血发作和慢性肾衰竭被确定为血栓栓塞事件的独立危险因素，而高血压、冠心病、心力衰竭和慢性肾衰竭与MACE独立相关。
通过24小时动态心电图检测到的PAT与血栓栓塞事件和MACE风险增加相关。
