Frequency of Cardiac Rhythm Abnormalities in a Half Million Adults.
Frequency of Cardiac Rhythm Abnormalities in a Half Million Adults.
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DOI：
10.1161/circep.118.006273
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发表时间：
2018-07
期刊：
影响因子：
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通讯作者：
Lubitz SA
中科院分区：
文献类型：
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作者：
Khurshid S;Choi SH;Weng LC;Wang EY;Trinquart L;Benjamin EJ;Ellinor PT;Lubitz SA
在社区居住的成年人中，心律异常的频率及其危险因素尚未得到很好的表征。我们确定了英国生物银行节律异常的频率，这是一个全国性的前瞻性队列。我们使用多变量比例风险回归测试了危险因素与事件节律异常之间的关联。在502,627名成年人（中位年龄58岁[四分位数差13]，54.4%为女性）中，2.35%的人有基线心律异常。患病率随年龄增长而增加，65-73岁人群患病率为4.84%。在3,368,332人-年的随访期间，检测到15,906例新的心律异常（每1000人-年4.72例；95%可信区间[CI]: 4.65-4.80）。房颤（3.11 / 1000人-年，95% CI: 3.05-3.17）、慢性心律失常（0.89 / 1000人-年，95% CI: 0.86-0.92）和传导系统疾病（1.06 / 1000人-年，95% CI: 1.02-1.09）比室上性心律失常（0.51 / 1000人-年，95% CI: 0.48-0.53）和室性心律失常（0.57 / 1000人-年，95% CI: 0.55-0.60）更为常见。年龄较大（危险比[HR]: 2.35 / 10年；95% CI: 2.29-2.41; p<0.01）、男性（HR 1.83; 95% CI: 1.76-1.89; p<0.01）、高血压（HR 1.49; 95% CI: 1.44-1.54; p<0.01）、慢性肾脏疾病（HR 1.95; 95% CI: 1.67-2.27; p<0.01）和心力衰竭（HR 1.99; 95% CI: 1.76-2.26; p<0.01）与新的心律异常相关。节律异常的频率在中老年社区居住的成年人是实质性的。心房颤动，慢速心律失常和传导系统疾病占大多数心律条件。
The frequency of cardiac rhythm abnormalities and their risk factors in community-dwelling adults are not well-characterized. We determined the frequency of rhythm abnormalities in the UK Biobank, a national prospective cohort. We tested associations between risk factors and incident rhythm abnormalities using multivariable proportional hazards regression. Of 502,627 adults (median age 58 years [interquartile range 13], 54.4% women), 2.35% had a baseline rhythm abnormality. The prevalence increased with age with 4.84% of individuals aged 65–73 years affected. During 3,368,332 person-years of follow-up, 15,906 new rhythm abnormalities were detected (4.72 per 1000 person-years; 95% confidence interval [CI]: 4.65–4.80). Atrial fibrillation (3.11 per 1000 person-years; 95% CI: 3.05–3.17), bradyarrhythmias (0.89 per 1000 person-years; 95% CI: 0.86–0.92), and conduction system diseases (1.06 per 1000 person-years; 95% CI: 1.02–1.09) were more common than supraventricular (0.51 per 1000 person-years; 95% CI: 0.48–0.53) and ventricular arrhythmias (0.57 per 1000 person-years; 95% CI: 0.55–0.60). Older age (hazard ratio [HR]: 2.35 per 10-year increase; 95% CI: 2.29–2.41; p<0.01), male sex (HR 1.83; 95% CI: 1.76–1.89; p<0.01), hypertension (HR 1.49; 95% CI: 1.44–1.54; p<0.01), chronic kidney disease (HR 1.95; 95% CI: 1.67–2.27; p<0.01), and heart failure (HR 1.99; 95% CI: 1.76–2.26; p<0.01) were associated with new rhythm abnormalities. The frequency of rhythm abnormalities in middle-aged to older community-dwelling adults is substantial. Atrial fibrillation, bradyarrhythmias, and conduction system diseases account for most rhythm conditions.