便秘对心肌梗死后患者因心力衰竭住院的影响：一项回顾性队列研究。
Effect of constipation on hospitalization due to heart failure in patients after myocardial infarction: a retrospective cohort study.
作者信息
Namiuchi Shigeto, Sunamura Shinichiro, Tanita Atsushi, Ogata Tsuyoshi, Noda Kazuki, Takii Toru, Nitta Yoshio, Yoshida Seijiro
机构信息
Department of Cardiology, Sendai City Medical Center, Sendai Open Hospital, 5-22-1 Tsurugaya, Miyagino-ku, Sendai, 983-0824, Japan.
Department of Cardiovascular Surgery, Sendai City Medical Center, Sendai Open Hospital, 5-22-1 Tsurugaya, Miyagino-ku, Sendai, 983-0824, Japan.
出版信息
BMC Cardiovasc Disord. 2025 May 28;25(1):410. doi: 10.1186/s12872-025-04874-7.
BACKGROUND
Patients with constipation after acute heart failure (HF) are at high risk of rehospitalization due to HF. Although HF after myocardial infarction (MI) affects patient outcomes, the relationship between constipation and patient prognosis after MI remains unclear. In this study, we evaluated the effects of constipation on the prognosis of patients with MI, focusing on hospitalization due to HF.
METHODS
We investigated 1,324 patients with MI admitted to our hospital between January 2012 and December 2023 (mean age, 68 ± 14 years; 76% males). Patients with constipation were defined as those using laxatives regularly.
RESULTS
During the follow-up period (median, 2.7 years), 115 patients died, and 99 were re-hospitalized due to HF. Landmark Kaplan-Meier analyses revealed incidences of 7.8% and 2.1% hospitalization due to HF from 0 to 0.5 years (log-rank: p < 0.0001) and 4.8% and 3.9% from 0.5 to 3 years (log-rank: p = 0.17) among patients with and without constipation, respectively. The adjusted Cox proportional hazards analysis revealed a significantly higher risk of hospitalization due to HF from 0 to 0.5 years in patients with constipation than in those without it (hazard ratio, 2.12; 95% confidence interval, 1.07-4.19; p = 0.032). However, no significant difference was found from 0.5 to 3 years (hazard ratio, 0.86; 95% confidence interval, 0.47-1.57; p = 0.63).
CONCLUSIONS
Constipation was strongly associated with a higher risk of hospitalization due to HF in patients with MI during the first 6 months after discharge.
背景
急性心力衰竭（HF）后便秘的患者因HF再次住院的风险很高。虽然心肌梗死（MI）后的HF会影响患者的预后，但便秘与MI后患者预后之间的关系仍不清楚。在本研究中，我们评估了便秘对MI患者预后的影响，重点关注因HF住院的情况。
方法
我们调查了2012年1月至2023年12月期间我院收治的1324例MI患者（平均年龄68±14岁；76%为男性）。便秘患者定义为定期使用泻药的患者。
结果
在随访期间（中位数为2.7年），115例患者死亡，99例因HF再次住院。标志性的Kaplan-Meier分析显示，便秘患者和非便秘患者在出院后0至0.5年因HF住院的发生率分别为7.8%和2.1%（对数秩检验：p<0.0001），在0.5至3年分别为4.8%和3.9%（对数秩检验：p=0.17）。调整后的Cox比例风险分析显示，便秘患者在出院后0至0.5年因HF住院的风险显著高于非便秘患者（风险比为2.12；95%置信区间为1.07-4.19；p=0.032）。然而，在0.5至3年期间未发现显著差异（风险比为0.86；95%置信区间为0.47-1.57；p=0.63）。
结论
出院后的前6个月，便秘与MI患者因HF住院的较高风险密切相关。
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