Mortality trends in patients diagnosed with first atrial fibrillation - A 21-year community-based study
Mortality trends in patients diagnosed with first atrial fibrillation - A 21-year community-based study
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DOI：
10.1016/j.jacc.2006.10.062
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发表时间：
2007-03-06
影响因子：
24
通讯作者：
Tsang, Teresa S. M.
中科院分区：
文献类型：
--
作者：
Miyasaka, Yoko;Barnes, Marion E.;Tsang, Teresa S. M.
Objectives本研究的目的是评估房颤（AF）的死亡率趋势，在community.Background有限的数据存在关于首次诊断为AF.Methods的患者的死亡率趋势，以社区为基础的队列的成年居民的Olmsted县，明尼苏达州，谁有心电图证实的首次记录的AF在1980年至2000年被确定，并随访至2004年或死亡。结果在总共4，618名被诊断为首次房颤的居民（平均年龄73 ± 14岁）中，3，085人在平均5.3 ± 5.0年的随访期间死亡。相对于年龄和性别匹配的明尼苏达州普通人群，死亡风险增加（p < 0.0001），前4个月内的风险比（HR）为9.62（95%置信区间[CI] 8.93至10.32），之后为1.66（95% CI 1.59至1.73）。考克斯比例风险模型显示，即使在校正合并症后，经年龄和性别校正的总死亡率也没有变化（2000年与1980年的HR：0.99; 95% CI 0.86至1.13; p = 0.84）。在二次分析中，死亡率没有变化被视为早期（前4个月内）或晚期（后4个月）死亡率为整个组或亚组的患者谁没有心血管疾病在baseline.Conclusions在这个队列中的新诊断为AF的患者，死亡风险高，尤其是在前4个月。没有证据表明21年来在总体死亡率、早期或晚期死亡率或无既往心血管疾病患者的死亡率方面有任何显著变化。(c)2007年美国心脏病学会基金会
Objectives The purpose of this study was to assess the mortality trends of atrial fibrillation (AF) in a community.Background Limited data exist regarding the mortality trends of patients diagnosed with first AF.Methods A community-based cohort of adult residents of Olmsted County, Minnesota, who had electrocardiogram-confirmed first-documented AF in the years 1980 to 2000 were identified and followed to 2004 or death. The primary outcome was all-cause mortality.Results Of a total of 4,618 residents (mean age 73 +/- 14 years) diagnosed with first AF, 3,085 died during a mean follow-up of 5.3 +/- 5.0 years. Relative to the age- and gender-matched general Minnesota population, the mortality risk was increased (p < 0.0001) with a hazard ratio (HR) of 9.62 (95% confidence interval [CI] 8.93 to 10.32) within the first 4 months and 1.66 (95% Cl 1.59 to 1.73) thereafter. Cox proportional hazards modeling showed no change in overall age- and gender-adjusted mortality (HR for the year 2000 vs. 1980: 0.99; 95% Cl 0.86 to :1.13; p = 0.84), even after adjustment for comorbidities. In secondary analyses, no changes in mortality were seen for early (within first 4 months) or late (after 4 months) mortality for the entire group or within the subgroup of patients who did not have cardiovascular disease at baseline.Conclusions In this cohort of patients newly diagnosed with AF, mortality risk was high, especially within the first 4 months. There was no evidence for any significant changes over the 21 years in terms of overall mortality, early or late mortality, or mortality among patients without pre-existing cardiovascular disease. (c) 2007 by the American College of Cardiology Foundation