心房颤动对老年冠心病患者预后的影响

Effects of atrial fibrillation on prognosis of elderly patients with coronary heart disease

中文关键词: 老年人  冠心病  心房颤动  预后

英文关键词: elderly  coronary heart disease  atrial fibrillation  prognosis

中文摘要:

      目的 探讨心房颤动(AF)对老年冠心病(CHD)患者预后的影响.方法 回顾性分析2020 年1 月—2020 年12月于上海交通大学医学院附属第九人民医院心内科住院的219 例老年CHD患者临床资料.根据受试者有无发生主要心血管不良事件(MACE)分为MACE组(n =59)和非MACE组(n =160).比较2 组的一般资料、血清学指标、超声心动图参数及冠脉病变情况.Kaplan-Meier曲线分析老年CHD患者2 年的MACE发生率;Cox比例风险模型分析老年CHD患者发生MACE的影响因素.结果 与非MACE组相比,MACE组高密度脂蛋白胆固醇水平较低,尿酸水平较高,房颤构成比较高,差异有统计学意义(P＜0.05).Kaplan-Meier生存分析显示,AF患者2 年无MACE生存时间少于非AF患者[(17.16±1.03)个月 vs(21.30±0.48)个月,P＜0.001].Cox比例风险模型结果显示,尿酸水平升高及合并AF是老年CHD患者发生MACE的风险因素(P＜0.05).结论 尿酸水平高或合并AF的老年CHD患者可能较易发生MACE.

英文摘要:

      Objective To explore the effects of atrial fibrillation(AF)on prognosis of elderly patients with coronary heart disease(CHD).Methods The clinical data of 219 elderly CHD patients admitted to Department of Cardiology,Ninth People's Hospital Affiliated to Medical College of Shanghai Jiaotong University from January 2020 to December 2020 were ret-rospectively analyzed.They were divided into MACE group(n =59)and non-MACE group(n =160)according to the occur-rence of major adverse cardiovascular events(MACE).The general data,serological indexes,echocardiographic parameters and coronary lesions were compared between the two groups.Kaplan-Meier curve was used to analyze the incidence of MACE in elderly CHD patients within 2 years.Cox proportional risk model was used to analyze the influencing factors for MACE in elderly CHD patients.Results Compared with the non-MACE group,the MACE group had lower level of high-density lipoprotein cho-lesterol,higher level of uric acid,and higher proportion of AF,with statistically significant differences(P＜0.05).Kaplan-Meier survival analysis showed that the 2-year survival time of AF patients without MACE was shorter than that of the non-AF patients[(17.16±1.03)months vs(21.30±0.48)months,P＜0.001].The Cox proportional risk model showed that elevated uric acid level and concomitant AF were risk factors for MACE in elderly CHD patients(P＜0.05).Conclusion Elderly CHD patients with high uric acid level or concomitant AF may be more prone to MACE.