Electrocardiographic Advanced Interatrial Block and Atrial Fibrillation Risk in the General Population.
Electrocardiographic Advanced Interatrial Block and Atrial Fibrillation Risk in the General Population.
复制标题
DOI：
10.1016/j.amjcard.2016.03.013
复制
发表时间：
2016-06-01
期刊：
影响因子：
--
通讯作者：
Soliman EZ
中科院分区：
文献类型：
--
作者：
O'Neal WT;Zhang ZM;Loehr LR;Chen LY;Alonso A;Soliman EZ
虽然晚期房间传导阻滞（aIAB）是一种已确定的心电图表型，但其在一般人群中的患病率、发生率和预后意义尚不清楚。我们在来自动脉粥样硬化风险社区（ARIC）研究的14，625名（平均年龄=54±5.8岁; 26%黑人; 55%女性）参与者中检查了aIAB的患病率，发病率和预后意义。aIAB是从4次研究访视（1987-1989、1990-1992、1993-1995和1996-1998）期间记录的数字心电图中检测到的。采用多变量Poisson回归模型和稳健的方差估计来检查aIAB发展的风险因素。使用考克斯回归计算aIAB（作为时间依赖性变量）与房颤（AF）之间相关性的风险比（HR）和95%置信区间（CI）。根据2010年的研究心电图数据、出院记录和死亡证明确定了AF。共有69名（0.5%）参与者在基线时患有aIAB，193名（1.3%）在随访期间发展为aIAB。aIAB的发病率为2.27（95%CI=1.97，2.61）/1000人-年。aIAB发生的危险因素包括年龄、男性、白色人种、抗高血压药物使用、低密度脂蛋白胆固醇、体重指数和收缩压。在调整了社会人口统计学、心血管危险因素和潜在混杂因素的考克斯回归分析中，aIAB与AF风险增加相关（HR=3.09，95%CI=2.51，3.79）。总之，aIAB在一般人群中并不罕见。发生aIAB的风险因素与AF的风险因素相似，aIAB的存在与AF的风险增加相关。
Although advanced inter-atrial block (aIAB) is an established electrocardiographic phenotype, its prevalence, incidence, and prognostic significance in the general population are unclear. We examined the prevalence, incidence, and prognostic significance of aIAB in 14,625 (mean age=54±5.8 years; 26% black; 55% female) participants from the Atherosclerosis Risk In Communities (ARIC) study. aIAB was detected from digital electrocardiograms recorded during 4 study visits (1987–1989, 1990–1992, 1993–1995, and 1996–1998). Risk factors for the development of aIAB were examined using multivariable Poisson regression models with robust variance estimates. Cox regression was used to compute hazard ratios (HR) and 95% confidence intervals (CI) for the association between aIAB, as a time-dependent variable, and atrial fibrillation (AF). AF was ascertained from study electrocardiogram data, hospital discharge records, and death certificates thorough 2010. A total of 69 (0.5%) participants had aIAB at baseline and 193 (1.3%) developed aIAB during follow-up. The incidence rate for aIAB was 2.27 (95%CI=1.97, 2.61) per 1000 person-years. Risk factors for aIAB development included age, male sex, white race, antihypertensive medication use, low-density lipoprotein cholesterol, body mass index, and systolic blood pressure. In a Cox regression analysis adjusted for socio-demographics, cardiovascular risk factors, and potential confounders, aIAB was associated with an increased risk for AF (HR=3.09, 95%CI=2.51, 3.79). In conclusion, aIAB is not uncommon in the general population. Risk factors for developing aIAB are similar to those for AF and the presence of aIAB is associated with an increased risk for AF.