Impact of atrial fibrillation on the risk of death
Impact of atrial fibrillation on the risk of death
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DOI：
10.1161/01.cir.98.10.946
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发表时间：
1998-09-08
期刊：
影响因子：
37.8
通讯作者：
Levy, D
中科院分区：
文献类型：
--
作者：
Benjamin, EJ;Wolf, PA;Levy, D
背景-心房颤动（AF）导致大量的发病率。这是不确定的，是否与AF独立于相关的心脏疾病和风险factors.Methods和结果，我们检查了死亡率的受试者55至94岁谁开发AF在40年的后续原始心脏研究队列。在最初的5209例受试者中，296例男性和325例女性（平均年龄分别为74岁和76岁）发生AF并符合合格标准。通过汇总logistic回归分析，在校正年龄、高血压、吸烟、糖尿病、左心室肥大、心肌梗死、充血性心力衰竭、心脏瓣膜病和卒中或短暂性脑缺血发作后，男性AF与死亡相关的OR为1.5（95%CI，1.2 - 1.8），女性为1.9（95%CI，1.5 - 2.2）。房颤引起的死亡风险在不同年龄之间没有显著差异。然而，有一个显着的AF-性别相互作用：AF减少了女性的生存优势。在二次多变量分析中，在无瓣膜性心脏病和既往心血管疾病的受试者中，AF仍然与死亡率过高显着相关，男女死亡率均约增加一倍。结论-在弗雷明汉心脏研究原始队列的受试者中，在调整与AF相关的既存心血管疾病后，AF与1.5至1.9倍的死亡风险相关。生存率下降。在男性和女性中以及在广泛的年龄范围内都存在AF。
Background-Atrial fibrillation (AF) causes substantial morbidity. It is uncertain whether AF is associated with excess mortality independent of associated cardiac conditions and risk factors.Methods and Results-We examined the mortality of subjects 55 to 94 years of age who developed AF during 40 years of follow-up of the original Framingham Heart Study cohort. Of the original 5209 subjects, 296 men and 325 women (mean ages, 74 and 76 years, respectively) developed AF and met eligibility criteria. By pooled logistic regression, after adjustment for age, hypertension, smoking, diabetes, left ventricular hypertrophy, myocardial infarction, congestive heart failure, valvular heart disease, and stroke or transient ischemic attack, AF was associated with an OR for death of 1.5 (95% CI, 1.2 to 1.8) in men and 1.9 (95% CI, 1.5 to 2.2) in women. The risk of mortality conferred by AF did not significantly vary by age. However, there was a significant AF-sex interaction: AF diminished the female advantage in survival. In secondary multivariate analyses, in subjects free of valvular heart disease and preexisting cardiovascular disease, AF remained significantly associated with excess mortality, with about a doubling of mortality in both sexes.Conclusions-In subjects from the original cohort of the Framingham Heart Study, AF was associated with a 1.5- to 1.9-fold mortality risk after adjustment for the preexisting cardiovascular conditions with which AF was related. The decreased survival. seen with AF was present in men and women and across a wide range of ages.