因室上性心动过速入住急诊科患者的死亡和血栓形成风险。
Risk of death and thrombosis in patients admitted to the emergency department with supraventricular tachycardias.
作者信息
Bucci Tommaso, Gerra Luigi, Lam Steven H M, Argyris Antonios A, Boriani Giuseppe, Proietti Riccardo, Bisson Arnaud, Fauchier Laurent, Lip Gregory Y H
机构信息
Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool and Heart and Chest Hospital, Liverpool, United Kingdom; Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.
Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool and Heart and Chest Hospital, Liverpool, United Kingdom; Cardiology Division, Department of Biomedical Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
出版信息
Heart Rhythm. 2025 Jun;22(6):1504-1511. doi: 10.1016/j.hrthm.2024.11.044. Epub 2024 Nov 28.
BACKGROUND
Few data are available on the clinical course of patients with supraventricular tachycardia (SVT).
OBJECTIVE
The purpose of this study was to assess the 1-year risk of adverse events in patients with SVT.
METHODS
This was a retrospective observational study conducted within TriNetX. On the basis of the International Classification of Diseases, Tenth Revision, Clinical Modification codes recorded at the emergency department admission, patients not taking oral anticoagulation were categorized into SVT, atrial fibrillation (AF), atrial flutter, or control (CTRL) groups. The primary outcome was the 1-year risk of a composite of all-cause death or thromboembolism. Cox regression analysis was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) after 1:1 propensity score matching. Sensitivity analyses were performed in clinically relevant subgroups. Incident AF and new oral anticoagulation prescriptions were reported during the study period.
RESULTS
We identified 23,524 patients with SVT (mean age 54.6±19.3 years; 14,000 [59.5%] women), 5413 with atrial flutter (66.9±15.7 years; 1907 [35.2%] women), 157,715 with AF (72.5±14.0 years, 68,813 [43.6%] women), and 150,807 CTRLs (43.0±17.4 years; 88,540 [58.7%] women). After propensity score matching, the risk of composite outcome in patients with SVT was higher than that in CTRLs (HR 2.89; 95% CI 2.65-3.17) but lower than that in patients with atrial flutter (HR 0.87; 95% CI 0.79-0.97) and those with AF (HR 0.69; 95% CI 0.65-0.73). The risk of adverse events in patients with SVT was more pronounced during the first 30 days in males, those aged ≥65 years, or those with multimorbidity. Patients with SVT had an increased risk of incident AF than did CTRLs.
CONCLUSION
The increased risk of adverse events in patients with SVT appears to be most pronounced in the short term and partly associated with the increased likelihood of incident AF.
背景
关于室上性心动过速（SVT）患者临床病程的数据较少。
目的
本研究旨在评估SVT患者1年不良事件风险。
方法
这是一项在TriNetX内进行的回顾性观察研究。根据急诊科入院时记录的国际疾病分类第十次修订版临床修订代码，未服用口服抗凝药的患者被分为SVT、心房颤动（AF）、心房扑动或对照组（CTRL）。主要结局是全因死亡或血栓栓塞综合事件的1年风险。在1:1倾向评分匹配后，使用Cox回归分析计算风险比（HRs）和95%置信区间（CIs）。在临床相关亚组中进行敏感性分析。报告研究期间发生的AF和新的口服抗凝药处方情况。
结果
我们确定了23524例SVT患者（平均年龄54.6±19.3岁；14000例[59.5%]为女性）、5413例心房扑动患者（66.9±15.7岁；1907例[35.2%]为女性）、157715例AF患者（72.5±14.0岁，68813例[43.6%]为女性）和150807例对照组患者（43.0±17.4岁；88540例[58.7%]为女性）。倾向评分匹配后，SVT患者发生综合结局的风险高于对照组（HR 2.89；95%CI 2.65 - 3.17），但低于心房扑动患者（HR 0.87；95%CI 0.79 - 0.97）和AF患者（HR 0.69；95%CI 0.65 - 0.73）。SVT患者不良事件风险在男性、年龄≥65岁或患有多种疾病的患者中，在前30天更为明显。SVT患者发生AF的风险高于对照组。
结论
SVT患者不良事件风险增加似乎在短期内最为明显，且部分与发生AF的可能性增加有关。
Zotero 插件