系统性硬化症患者的心律失常:瑞典登记研究中的发病率、风险因素及其对死亡率的影响。

IF 5.1 2区 医学 Q1 RHEUMATOLOGY
Majd Bairkdar, Zihan Dong, Pontus Andell, Roger Hesselstrand, Marie Holmqvist
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引用次数: 0

摘要

研究目的本研究的目的是研究系统性硬化症(SSc)患者随着时间推移患心律失常的风险及其亚型,评估SSc患者心律失常的潜在风险因素,并探讨心律失常是否与死亡率相关:我们利用瑞典全国范围内的登记册,确定了 2004-2019 年期间发病的 SSc 患者和匹配的普通人群比较者(1:10)。主要结果是偶发心律失常。随访始于 SSc 诊断之日,止于主要结局、死亡、移民或 2019 年 12 月 31 日。我们估算了心律失常的总体发生率和亚型分层发生率,并使用灵活的参数模型探讨了与诊断后时间相关的相对风险。我们使用 Cox 回归法研究心律失常的风险因素以及心律失常与死亡率的关系:我们确定了 1565 名患者和 16 009 名比较者。在 SSc 患者和对照组中,心律失常的总发病率分别为每 10,000 人年 255 例(95% CI 221 至 295 例)和 119 例(95% CI 112 至 127 例),对应的 IRR 为 2.1(95% CI 1.8 至 2.5)。与对照组相比,SSc 患者在随访第一年的危险差异最大(心律失常的 HR 为 3.0;95% CI 为 2.3 至 3.8)。心房颤动和扑动是最常见的心律失常亚型。男性、指数年龄和肺动脉高压是导致 SSc 患者心律失常的重要风险因素。心律失常的发生与死亡率显著相关(HR 2.2;95% CI 1.6 至 3.0):结论:与普通人群相比,SSc 的心律失常发生率较高。心律失常似乎是 SSc 的早期表现,与较高的死亡率有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Arrhythmia in patients with systemic sclerosis: incidence, risk factors and impact on mortality in a Swedish register-based study.

Objectives: The objectives of this study are to study the risk of developing cardiac arrhythmia and its subtypes over time in patients with systemic sclerosis (SSc), to assess potential risk factors for arrhythmia in SSc and to explore whether arrhythmia is associated with mortality.

Methods: We used nationwide Swedish registers to identify patients with incident SSc 2004-2019 and matched general population comparators (1:10). The primary outcome was incident arrhythmia. Follow-up started at the date of SSc diagnosis and ended at the primary outcome, death, emigration or 31 December 2019. We estimated the incidence of arrhythmia overall and stratified by subtype and explored the relative risk in relation to time since diagnosis using flexible parametric models. We used Cox regression to study risk factors for arrhythmia and the association of arrhythmia with mortality.

Results: We identified 1565 patients and 16 009 comparators. The overall incidence of arrhythmia was 255 (95% CI 221 to 295) and 119 (95% CI 112 to 127) per 10 000 person years in patients with SSc and comparators, respectively, corresponding to an IRR of 2.1 (95% CI 1.8 to 2.5). The greatest hazard difference between patients with SSc compared with the comparators was seen in the first year of follow-up (HR for arrhythmia 3.0; 95% CI 2.3 to 3.8). Atrial fibrillation and flutter were the most common arrhythmia subtypes. Male sex, index age and pulmonary arterial hypertension were significant risk factors for arrhythmia in SSc. Incident arrhythmia was significantly associated with mortality (HR 2.2; 95% CI 1.6 to 3.0).

Conclusion: SSc is associated with higher incidence of cardiac arrhythmia compared with general population. Arrhythmia seems to be an early manifestation of SSc and is associated with higher mortality.

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来源期刊
RMD Open
RMD Open RHEUMATOLOGY-
CiteScore
7.30
自引率
6.50%
发文量
205
审稿时长
14 weeks
期刊介绍: RMD Open publishes high quality peer-reviewed original research covering the full spectrum of musculoskeletal disorders, rheumatism and connective tissue diseases, including osteoporosis, spine and rehabilitation. Clinical and epidemiological research, basic and translational medicine, interesting clinical cases, and smaller studies that add to the literature are all considered.
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