老年患者心房颤动的患病率以及心房颤动与既往和新发血栓栓塞性卒中的关联。
Prevalence of atrial fibrillation and association of atrial fibrillation with prior and new thromboembolic stroke in older patients.
作者信息
Aronow W S, Ahn C, Gutstein H
机构信息
Hebrew Hospital Home, Bronx, New York 10475, USA.
出版信息
J Am Geriatr Soc. 1996 May;44(5):521-3. doi: 10.1111/j.1532-5415.1996.tb01436.x.
OBJECTIVE
To correlate atrial fibrillation with the incidence of new thromboembolic (TE) stroke in older patients with and without prior TE stroke.
DESIGN
In a prospective study of 2101 older patients, electrocardiograms showed that atrial fibrillation was present in 283 patients (13%). At 42-month mean follow-up, atrial fibrillation was associated with the incidence of new TE stroke in patients with and without prior TE stroke.
SETTING
A large long-term health care facility where 2101 older patients were studied.
PATIENTS
The 2101 patients included 1451 women and 650 men, mean age 81 +/- 8 years (range 60 to 103).
MEASUREMENTS AND MAIN RESULTS
Atrial fibrillation was present in 283 of 2101 patients (13%). The mean age was 84 +/- 7 years in patients with atrial fibrillation and 81 +/- 8 years in patients with sinus rhythm (P = .0001). The prevalence of atrial fibrillation was 5% in patients aged 60 to 70 years, 14% in patients aged 71 to 80 years, 13% in patients aged 81 to 90 years, and 22% in patients aged 91 to 103 years (P < .0001). Mean follow-up was 31 +/- 18 months in patients with atrial fibrillation and 44 +/- 27 months in patients with sinus rhythm (P = .0001). Previous TE stroke occurred in 123 of 283 patients (43%) with atrial fibrillation and in 431 of 1818 patients (24%) with sinus rhythm (P < .0001). New TE stroke occurred in 131 of 283 patients (46%) with atrial fibrillation and in 303 of 1818 patients (17%) with sinus rhythm (P < .0001). The log-rank test showed that patients with atrial fibrillation had a significantly higher probability of developing new TE stroke than those with sinus rhythm (P < .0001). The multivariate Cox regression model showed that independent risk factors for new TE stroke were male sex (relative risk = 1.3), prior TE stroke (relative risk = 3.1), and atrial fibrillation (relative risk = 3.3).
CONCLUSIONS
Atrial fibrillation, prior TE stroke, and male sex are independent risk factors for the development of new TE stroke in older patients.
目的
比较有或无既往血栓栓塞性（TE）性卒中的老年患者中，房颤与新发TE性卒中发生率的相关性。
设计
在一项对2101例老年患者的前瞻性研究中，心电图显示283例患者（13%）存在房颤。在平均42个月的随访中，无论有无既往TE性卒中，房颤均与新发TE性卒中的发生率相关。
地点
一家对2101例老年患者进行研究的大型长期医疗保健机构。
患者
2101例患者包括1451名女性和650名男性，平均年龄81±8岁（范围60至103岁）。
测量指标及主要结果
2101例患者中有283例（13%）存在房颤。房颤患者的平均年龄为84±7岁，窦性心律患者的平均年龄为81±8岁（P = .0001）。60至70岁患者中房颤的患病率为5%，71至80岁患者中为14%，81至90岁患者中为13%，91至103岁患者中为22%（P < .0001）。房颤患者的平均随访时间为31±18个月，窦性心律患者为44±...
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