Recent trends in the incidence rates of and death rates from atrial fibrillation complicating initial acute myocardial infarction: A community-wide perspective
Recent trends in the incidence rates of and death rates from atrial fibrillation complicating initial acute myocardial infarction: A community-wide perspective
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DOI：
10.1067/mhj.2002.120410
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发表时间：
2002-03-01
影响因子：
4.8
通讯作者：
Gore, JM
中科院分区：
文献类型：
--
作者：
Goldberg, RJ;Yarzebski, J;Gore, JM
背景：关于心房纤颤（AF）并发急性心肌梗死（AMI）的发病率和死亡率的最新趋势，可获得的信息有限。本研究的目的是探讨房颤并发急性心肌梗死的影响和趋势。方法我们对马萨诸塞州伍斯特市的2596名居民进行了纵向研究，这些居民在1990年至1997年的5年期间在所有地区医院住院，患有急性心肌梗死和既往无房颤。随着时间的推移，发生AF的患者比例显著下降（1990年为18%; 1997年为11%）。在控制了可能影响AF风险的因素后，最近几年住院的患者发生AF的风险仍显著低于1990年住院的患者。即使在控制了其他预后因素后，AF患者在住院期间死亡的可能性也高于无AF患者。尽管AF有不良影响，但我们观察到在最近几年的研究中，AF患者的住院生存率有改善的趋势。AF患者出院后的长期死亡率高于未发生AF的患者，虽然这些差异在调整其他因素后有所减弱。结论该社区的结果-广泛的研究表明房颤并发AMI的发生率显著下降。尽管房颤患者的住院死亡率较高，但我们观察到这些患者的生存率有提高的趋势。房颤仍然是AMI的常见并发症，有针对性的治疗措施似乎是必要的。
Background Limited information is available about recent trends in the incidence and death rates from atria] fibrillation (AF) complicating acute myocardial infarction (AMI). The purpose of this study was to examine the impact and trends over time of AF complicating initial AMIMethods We conducted a longitudinal study of 2596 residents of the Worcester, Massachusetts, metropolitan area with initial AMI and without previous AF who were hospitalized at all area hospitals in 5 annual periods between 1990 and 1997.Results A total of 13% of hospitalized patients developed AF, There was a marked decrease in the proportion of patients who developed AF over time (18% in 1990; 11% in 1997). Patients hospitalized during the most recent study years remained at significantly lower risk for developing AF than patients hospitalized in 1990 after controlling for factors that might affect the risk of AF. Patients with AF were more likely to die during hospitalization than those without AF even after controlling for other prognostic factors. Despite the adverse impact of AF, we observed trends toward improved hospital survival during the most recent study years in patients developing AF. Patients discharged after developing AF had higher long-term death rates than patients who did not develop AF, although these differences were attenuated after adjusting for other factors.Conclusions The results of this community-wide study suggest a significant decline in the incidence of AF complicating AMI Although patients with AF had higher hospital death rates, we observed trends of improved survival for these patients. AF remains a common complication of AMI to which targeted treatment efforts appear warranted.