亚洲心房颤动患者的教育状况与不良后果风险:来自前瞻性 APHRS-AF 登记处的报告。

Minerva medica Pub Date : 2024-06-01 Epub Date: 2024-05-09 DOI:10.23736/S0026-4806.24.09159-6
Tommaso Bucci, Giulio F Romiti, Bernadette Corica, Alena Shantsila, Wee-Siong Teo, Hyung-Wook Park, Wataru Shimizu, Hung-Fat Tse, Marco Proietti, Tze-Fan Chao, Gregory Y H Lip
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引用次数: 0

摘要

研究背景本研究旨在评估教育状况(ES)对亚洲心房颤动(AF)患者临床病程的影响:方法:我们使用了前瞻性 APHRS-AF 登记处的数据。教育程度分为:低(小学)、中(中学)和高(大学)。主要结果是全因死亡、血栓栓塞事件、急性冠状动脉综合征和心力衰竭的复合结果。次要结果为主要结果的每个组成部分、心血管死亡和大出血。主要和次要结果的一年期风险通过 Cox 回归进行评估。此外,还对心房颤动更好护理(ABC)路径的依从性进行了评估:在2697名房颤患者(69±12岁,34.8%为女性)中,34.6%为低ES;37.3%为中ES;28.1%为高ES。与中高ES患者相比,低ES患者年龄更大,女性更多,心血管风险因素发生率更高,ABC路径依从性更低(30.4%对40.2%,PConclusions:在亚洲心房颤动患者中,低ES与高死亡率相关。为减轻这些患者的心血管负担,有必要加强教育并将血沉评估纳入心房颤动综合护理方法中。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Educational status and the risk of adverse outcomes in Asian patients with atrial fibrillation: a report from the prospective APHRS-AF Registry.

Background: The aim of this study was to evaluate the impact of educational status (ES) on the clinical course of Asian patients with atrial fibrillation (AF).

Methods: We used data from the prospective APHRS-AF Registry. ES was classified as follows: low (primary school), medium (secondary), and high (University). The primary outcome was a composite of all-cause death, thromboembolic events, acute coronary syndrome, and heart failure. Secondary outcomes were each component of the primary outcome, cardiovascular death, and major bleeding. The one-year risk of primary and secondary outcomes was assessed through Cox-regressions. Adherence to the Atrial fibrillation Better Care (ABC) pathway was assessed.

Results: Among 2697 AF patients (69±12 years, 34.8% females), 34.6% had low ES; 37.3% had medium ES; and 28.1% had high ES. Compared to patients with medium-high ES, patients with low ES were older, more often females, with a higher prevalence of cardiovascular risk factors, and a lower ABC pathway adherence (30.4% vs. 40.2%, P<0.001). On multivariable analysis, low ES was associated with a higher risk for the primary outcome (HR 1.52,95%CI 1.11-2.06) and all-cause death (HR 1.76,95%CI 1.10-2.83) than medium-high ES. A significant interaction was found for the risk of composite outcome among the different age strata, with the higher risk in the elderly (P for int=0.008), whereas the beneficial effect of the ABC pathway was irrespective of ES (P for int=0.691).

Conclusions: In Asian AF patients, low ES is associated with high mortality. Efforts to improve education and include ES evaluation in the integrated care approach for AF are necessary to reduce the cardiovascular burden in these patients.

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