Frequent premature atrial complexes predict new occurrence of atrial fibrillation and adverse cardiovascular events
Frequent premature atrial complexes predict new occurrence of atrial fibrillation and adverse cardiovascular events
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DOI：
10.1093/europace/eur389
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发表时间：
2012-07-01
期刊：
影响因子：
6.1
通讯作者：
Siu, Chung-Wah
中科院分区：
文献类型：
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作者：
Chong, Boon-Hor;Pong, Vincent;Siu, Chung-Wah
为探讨房性早搏(PAC)和新房颤(AF)的基线频率与不良心血管事件的关系，对4 2 8例无房颤或器质性心脏病的患者进行24 h心电图心悸、头晕或晕厥监测。107例PAC数量位于前四分位数(即每天100个PAC)的患者被定义为频繁PAC。经6.1年随访，31例(29例)频繁PAC患者发生房颤，而29例(9例)PACs为100次/天(P<0.01)。COX回归分析显示，频发PAC[危险比(HR)：3.22(95可信区间：1.95.5；P 0.001)]、年龄75岁(HR：2.3；95 CI：1.33.9；P 0.004)、冠状动脉疾病(HR：2.5；95 CI：1.44.4；P 0.002)是新发生房颤的独立预测因素。关于复合终点(缺血性中风、心力衰竭和死亡)，频繁发生PAC的患者比没有PAC的患者风险更高(34.5vs.19.3)(HR：1.95；95CI：1.373.50；P 0.001)。COX回归分析显示年龄75岁(HR：2.2；95 CI：1.473.41；P 0.001)、冠状动脉疾病(HR：2.2，95 CI：1.423.44，P 0.001)和频繁PAC(HR：1.6；95 CI：1.042.44；P 0.03)是继发复合终点的独立预测因素。
To investigate the relation between baseline frequency of premature atrial complexes (PACs) and new atrial fibrillation (AF) and adverse cardiovascular events.Four hundred and twenty-eight patients without AF or structural heart disease undergoing 24 h electrocardiography monitoring for palpitations, dizziness, or syncope were recruited. One hundred and seven patients with number of PACs at the top quartile (i.e. 100PACs/day) were defined to have frequent PACs. After 6.1-year follow-up, 31 patients (29) with frequent PACs developed AF compared with 29 patients (9) with PACs 100/day (P 0.01). Cox regression analysis revealed that frequent PACs [hazard ratio (HR): 3.22 (95 confidence interval (CI): 1.95.5; P 0.001)], age 75 years (HR: 2.3; 95 CI: 1.33.9; P 0.004), and coronary artery disease (HR: 2.5; 95 CI: 1.44.4; P 0.002) were independent predictors for new AF. Concerning the composite endpoint (ischaemic stroke, heart failure, and death), patients with frequent PACs were more at risk than those without (34.5 vs. 19.3) (HR: 1.95; 95 CI: 1.373.50; P 0.001). Cox regression analysis showed that age 75 years (HR: 2.2; 95 CI: 1.473.41; P 0.001), coronary artery disease (HR: 2.2, 95 CI: 1.423.44, P 0.001), and frequent PACs (HR: 1.6; 95 CI: 1.042.44; P 0.03) were independent predictors for the secondary composite endpoint.Frequent PACs predict new AF and adverse cardiovascular events.