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心肌梗死后室性早搏与死亡率

Ventricular premature beats and mortality after myocardial infarction.

作者信息

Ruberman W, Weinblatt E, Goldberg J D, Frank C W, Shapiro S

出版信息

N Engl J Med. 1977 Oct 6;297(14):750-7. doi: 10.1056/NEJM197710062971404.

Abstract

To assess the role of ventricular premature beats in influencing mortality of coronary patients, 1739 men with prior myocardial infarction were monitored for ectopic activity for one hour at a standard base-line examination, and followed for mortality for periods up to four years (average, 24.4 months). Analyses of survival taking into account other important prognostic variables establish that the presence of complex premature beats (R on T, runs of 2 or more, multiform or bigeminal premature beats) in the monitoring hour is associated with a risk of sudden coronary death three times that of the men free of complex ventricular premature beats. The corresponding risk of death from any cause is twice that of men without such complex beats in the hour. These arrhythmias make an independent contribution to increased risk of death that persists over the length of this observation period.

摘要

为评估室性早搏在影响冠心病患者死亡率方面的作用,对1739例既往有心肌梗死的男性患者在标准基线检查时进行1小时异位活动监测,并对其进行长达4年(平均24.4个月)的死亡率随访。在考虑其他重要预后变量的情况下对生存情况进行分析发现,监测期间出现复杂性早搏(R波落在T波上、连发2次或更多、多形性或二联律早搏)的男性发生冠状动脉猝死的风险是无复杂性室性早搏男性的3倍。该时段内任何原因导致的相应死亡风险是无此类复杂性早搏男性的2倍。这些心律失常对死亡风险增加有独立影响,且在该观察期内持续存在。

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