A population-based study of mortality among patients with atrial fibrillation or flutter
A population-based study of mortality among patients with atrial fibrillation or flutter
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DOI：
10.1016/s0002-9343(02)01253-6
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发表时间：
2002-10-01
影响因子：
5.9
通讯作者：
Hayes, J
中科院分区：
文献类型：
--
作者：
Vidaillet, H;Granada, JF;Hayes, J
目得：确定与心房扑动和心房颤动在一般population.SubjecTS和方法：使用马什菲尔德流行病学研究区，一个数据库，捕获几乎所有的医疗保健和死亡的58,820居民，我们确定了患者诊断为心房扑动或心房颤动，从1991年7月1日至1995年6月30日。患者进行了前瞻性随访，并与一组对照组相比，没有这些心律失常。结果：共完成了4775人年的随访577例患者和577名对照。与对照组相比，房颤或房扑患者在6个月时的死亡率高出近7.8倍（95%置信区间[CI]：4.1 - 15）和2.5倍（95% CI：2.0至3.1; P < 0.0001）（平均值[+/- SD]为3.6 +/- 2.3年;范围：1天至7.3年）。6个月时，单纯房扑患者的死亡率略高于对照组，低于房颤（伴或不伴房扑）患者的三分之一（P = 0.02）。然而，在最后一次随访中，心房扑动患者的死亡率更高（风险比[HR] = 1.7; 95% CI：1.2 - 2.6; P = 0.007），房颤（HR = 2.4; 95% CI：1.9至3.1; P < 0.0001），或同时伴有房性心律失常（HR = 2.5; 95%CI：1.9 - 3.3; P < 0.0001）。结论：在一般人群中，心房扑动和心房颤动都是晚期死亡率增加的独立预测因素。在最初诊断为房扑后的6个月内，相对良性的过程表明，早期诊断和治疗这些患者可能会提高他们的长期生存率。(C)2002年，Excerpta Medica，Inc.
PURPOSE: To determine the mortality associated with atrial flutter and atrial fibrillation in the general population.SUBJECTS AND METHODS: Using the Marshfield Epidemiologic Study Area, a database that captures nearly all medical care and deaths among its 58,820 residents, we identified patients diagnosed with atrial flutter or atrial fibrillation from July 1, 1991, through June 30, 1995. Patients were followed prospectively and compared with a group of controls without these arrhythmias.RESULTS: A total of 4775 person-years of follow-up were completed in 577 patients and 577 controls. Compared with controls, mortality among patients with atrial fibrillation or flutter was nearly 7.8-fold higher at 6 months (95% confidence interval [CI]: 4.1 to 15) and 2.5-fold higher (95% CI: 2.0 to 3.1; P < 0.0001) at the last follow-up (mean [+/- SD] of 3.6 +/- 2.3 years; range, 1 day to 7.3 years). At 6 months, mortality amongpatients with atrial flutter alone was somewhat greater than in controls and less than one third that of those with atrial fibrillation (with or without atrial flutter) (P = 0.02). At the last follow-up, however, mortality was greater among patients with atrial flutter (hazard ratio [HR] = 1.7; 95% CI: 1.2 to 2.6; P = 0.007), atrial fibrillation (HR = 2.4; 95% CI: 1.9 to 3.1; P < 0.0001), or both atrial arrhythmias (HR = 2.5; 95% CI: 1.9 to 3.3; P < 0.0001) when compared with controls in models that adjusted for cardiovascular risk factors.CONCLUSION: In the general population, both atrial flutter and atrial fibrillation are independent predictors of increased late mortality. The relatively benign course during the 6-month period after the initial diagnosis of atrial flutter suggests that early diagnosis and treatment of these patients may improve their long-term survival. (C) 2002 by Excerpta Medica, Inc.