房颤模式与死亡率和心血管事件的关联:MISOAC-AF试验的意义。

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS

ACS Applied Bio Materials Pub Date : 2022-01-01 DOI:10.1177/10742484211069422

Amalia Baroutidou, Anastasios Kartas, Athanasios Samaras, Andreas S Papazoglou, Eleni Vrana, Dimitrios V Moysidis, Evangelos Akrivos, Anastasios Papanastasiou, Ioannis Vouloagkas, Michail Botis, Evangelos Liampas, Artemios G Karagiannidis, Efstratios Karagiannidis, Georgios Efthimiadis, Haralambos Karvounis, Apostolos Tzikas, George Giannakoulas

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引用次数: 1

摘要

目的:本回顾性队列研究旨在评估不同心房颤动(AF)时间模式的预后意义:首次诊断，阵发性，持续性或永久性房颤。方法:在MISOAC-AF试验(NCT02941978)的回顾性分析中，共分析了2015年至2018年间从心脏病病房出院的1052例房颤患者(中位年龄76岁)。采用Kaplan-Meier和cox回归分析比较AF类型中全因死亡率的主要结局、卒中、大出血的次要结局和心血管(CV)死亡率或住院率的复合结局。结果:121例(11.2%)患者首次诊断为房颤，356例(33%)为阵发性房颤，575例(53.2%)为持续性或永久性房颤。在中位随访31个月(四分位数间隔10至52个月)期间，37.3%的患者死亡。与阵发性房颤相比，持续性或永久性房颤患者的死亡率更高(校正危险比(aHR)， 1.37;95%可信区间[CI]， 1.08-1.74, P = 0.009)，但相似的CV死亡率或住院率(aHR, 1.09;95% ci, 0.91-1.31, p = 0.35)。与首次诊断的房颤相比，持续性或永久性房颤患者的死亡率相似(aHR, 1.26;95% CI, 0.87-1.82, P = 0.24)，但CV死亡率或住院率较高(aHR, 1.35;95% ci, 1.01-1.8, p = 0.04)。卒中和大出血事件在房颤类型间无差异(均P > 0.05)。结论:总之，在最近住院的合并房颤患者中，与阵发性和首次诊断的房颤相比，持续性或永久性房颤的死亡率和发病率更高。

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Associations of Atrial Fibrillation Patterns With Mortality and Cardiovascular Events: Implications of the MISOAC-AF Trial.

Aim: This retrospective cohort study aimed to evaluate the prognostic implications of the distinct atrial fibrillation (AF) temporal patterns: first diagnosed, paroxysmal, and persistent or permanent AF.

Methods: In this post hoc analysis of the MISOAC-AF trial (NCT02941978), a total of 1052 patients with AF (median age 76 years), discharged from the cardiology ward between 2015 and 2018, were analyzed. Kaplan-Meier and Cox-regression analyses were performed to compare the primary outcome of all-cause mortality, the secondary outcomes of stroke, major bleeding and the composite outcome of cardiovascular (CV) mortality or hospitalization among AF patterns.

Results: Of patients, 121 (11.2%) had first diagnosed, 356 (33%) paroxysmal, and 575 (53.2%) persistent or permanent AF. During a median follow-up of 31 months (interquartile range 10 to 52 months), 37.3% of patients died. Compared with paroxysmal AF, patients with persistent or permanent AF had higher mortality rates (adjusted hazard ratio (aHR), 1.37; 95% confidence interval [CI], 1.08-1.74, P = .009), but similar CV mortality or hospitalization rates (aHR, 1.09; 95% CI, 0.91-1.31, P = .35). Compared with first diagnosed AF, patients with persistent or permanent AF had similar mortality (aHR, 1.26; 95% CI, 0.87-1.82, P = .24), but higher CV mortality or hospitalization rates (aHR, 1.35; 95% CI, 1.01-1.8, P = .04). Stroke and major bleeding events did not differ across AF patterns (all P > .05).

Conclusions: In conclusion, in recently hospitalized patients with comorbid AF, the presence of persistent or permanent AF was associated with a higher incidence of mortality and morbidity compared with paroxysmal and first diagnosed AF.

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来源期刊

ACS Applied Bio Materials Chemistry-Chemistry (all)

CiteScore

9.40

自引率

2.10%

发文量

464

期刊介绍： ACS Applied Bio Materials is an interdisciplinary journal publishing original research covering all aspects of biomaterials and biointerfaces including and beyond the traditional biosensing, biomedical and therapeutic applications. The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrates knowledge in the areas of materials, engineering, physics, bioscience, and chemistry into important bio applications. The journal is specifically interested in work that addresses the relationship between structure and function and assesses the stability and degradation of materials under relevant environmental and biological conditions.