Risk of death and thrombosis in patients admitted to the emergency department with supraventricular tachycardias.

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart rhythm Pub Date : 2024-11-28 DOI:10.1016/j.hrthm.2024.11.044

Tommaso Bucci, Luigi Gerra, Steven H M Lam, Antonios A Argyris, Giuseppe Boriani, Riccardo Proietti, Arnaud Bisson, Laurent Fauchier, Gregory Y H Lip

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引用次数: 0

Abstract

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.

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急诊科室上性心动过速患者的死亡和血栓形成风险

背景：很少有关于室上性心动过速（SVT）患者临床病程的资料。目的：评价SVT患者1年不良事件发生风险。方法：采用TriNetX进行回顾性研究。根据急诊科入院时记录的ICD-10-CM代码，将未使用口服抗凝剂的患者分为SVT、心房颤动（AF）、心房扑动或对照组（CTRL）。主要终点是1年全因死亡和血栓栓塞的综合风险。采用cox -回归分析，在1:1倾向评分匹配（PSM）后得到风险比（hr）和95%置信区间（CI）。对临床相关亚组进行敏感性分析。在研究期间报告了AF事件和新的OAC处方。结果：共有23,524例SVT患者（54.6±19.3岁，女性59.5%），5,413例心房扑动患者（66.9±15.7岁，女性35.2%），157,715例AF患者（72.5±14.0岁，女性43.6%），150,807例CTRL患者（43.0±17.4岁，女性58.7%）。PSM后，SVT患者复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）和房颤患者（HR 0.69, 95%CI 0.65-0.73）。在SVT患者中，不良事件的风险在前30天更为明显，在男性中，年龄≥65岁，或患有多种疾病。与对照组相比，SVT患者发生房颤的风险增加。结论：SVT患者不良事件的高风险在短期内最为明显，部分与房颤发生的可能性增加有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Heart rhythm 医学-心血管系统

CiteScore

10.50

自引率

5.50%

发文量

1465

审稿时长

24 days

期刊介绍： HeartRhythm, the official Journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, is a unique journal for fundamental discovery and clinical applicability. HeartRhythm integrates the entire cardiac electrophysiology (EP) community from basic and clinical academic researchers, private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our EP community. The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal health care policies and standards.