ПРЕДИКТОРИ ЗРОСТАННЯ РИЗИКУ СМЕРТІ ВІД УСІХ ПРИЧИН У ПАЦІЄНТІВ ІЗ ПОСТІЙНОЮ ФОРМОЮ ФІБРИЛЯЦІЇ ПЕРЕДСЕРДЬ НЕКЛАПАННОЇ ЕТІОЛОГІЇ

Atrial fibrillation (AF) is one of the most common arrhythmias in the heart, and it is a potent risk factor for the development of cardiovascular disease (CVD) and death from all causes.The aim of the study – to identify predictors of the risk of death from all causes in patients with a persistent form of atrial fibrillation (PFTF) of non-valvular etiology.Materials and Methods. We performed a retrospective analysis of 146 histories of diseases of patients with non-valvular PA F with inpatient treatment, 16 patients died at the time of the study, which were subject to further analysis. For heart rate controll, the therapy of BB (bisoprolol and carvedilol) was performed. The endpoint of the study was death from all causes. An assessment of heart rate control on ECG data and echocardiographic parameters were performed at the time of discharge.Results and Discussion. In the group of patients undergoing analysis, strict heart rate control was prevalent. There was an increase in the size of both atriums, the volume of LV , its moderate hypertrophy, moderate regurgitation on the mitral and tricuspidal valve according to the echocardiography data. At the time of discharge, the dosage for heart rate controll was: bisoprolol – (5.6±2) mg, carvedilol – (20±2.3) mg, digoxin – (0.19±0.07) mg. Then we determined the predictors risk increasing of death from all causes. Onefactor regression analysis revealed that the risk of death from all causes among patients with PA F significantly increased with a history of COPD in patient anamnesis (p = 0.01), as well as increase in the NYHA functional class of HF on the scale for each unit (p = 0.046). In multivariate regression analysis, where indicators were selected using stepwise method, the risk of death from all causes in patients with PA F in the presence of COPD in patient anamnesis increased significantly when standardized by other risk factors (p=0.01).Conclusions. Independent risk increasing predictors of the death from all causes in patients with PA F non-valvular etiology are the presence of COPD in patient anamnesis and the increasing of NYHA functional class HF. The death risk from all causes in these patients significantly increases with the presence of COPD in patient anamnesis when standardized by other factors. The study complements the existing data on the importance of heart rate controll in patients with PA F and the correctness of the treatment concomitant HF. The obtained results are new and important for revealing the reasons of high mortality of this category of patients and ways of correction of their treatment.