Trends in atrial fibrillation in patients hospitalized with an acute coronary syndrome.
Trends in atrial fibrillation in patients hospitalized with an acute coronary syndrome.
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DOI：
10.1016/j.amjmed.2012.05.024
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发表时间：
2012-11
影响因子：
5.9
通讯作者：
Goldberg, Robert J.
中科院分区：
文献类型：
--
作者：
McManus, David D.;Huang, Wei;Domakonda, Kunal V.;Ward, Jeanine;Saczysnki, Jane S.;Gore, Joel M.;Goldberg, Robert J.
心房颤动在心血管疾病患者中很常见，并且是急性冠状动脉综合征的常见并发症。需要有关因急性冠状动脉综合征住院的患者中已有和新发房颤的严重程度、临床特征、治疗和预后影响的最新趋势的数据。研究人群包括 2000 年至 2007 年间在全球急性冠脉事件登记研究的 113 个地点因急性冠脉综合征住院的 59,032 名患者。 4,494 名急性冠脉综合征参与者 (7.6%) 报告有房颤病史，3,112 名参与者 (5.3%) 在住院期间出现新发房颤。研究期间，新发房颤发生率（5.5% 至 4.5%）和既往房颤发生率（7.4% 至 6.7%）均有所下降。既往心房颤动与年龄较大和心血管疾病负担较大有关，而新发心房颤动与急性冠状动脉综合征的严重程度密切相关。与没有房颤的患者相比，房颤患者接受循证治疗的可能性较小，而且更有可能出现院内并发症，包括心力衰竭。新发房颤患者和既往房颤患者的总体医院死亡率分别为 14.5% 和 8.9%，而无房颤患者的医院总体死亡率为 1.2%。在研究期间，房颤患者的短期死亡率有所下降。尽管心房颤动的发病率和死亡率有所降低，但这种心律失常对因急性冠状动脉综合征住院的患者的生存产生了显着的不利影响。有机会改善对患有房颤或有房颤风险的急性冠状动脉综合征患者的识别和治疗，以减少这种心律失常的发生率和由此产生的并发症。
Atrial fibrillation is common among patients with cardiovascular disease and is a frequent complication of the acute coronary syndrome. Data are needed on recent trends in the magnitude, clinical features, treatment, and prognostic impact of pre-existing and new-onset atrial fibrillation in patients hospitalized with an acute coronary syndrome. The study population consisted of 59,032 patients hospitalized with an acute coronary syndrome at 113 sites in the Global Registry of Acute Coronary Events Study between 2000 and 2007. 4,494 participants (7.6%) with acute coronary syndrome reported a history of atrial fibrillation and 3,112 (5.3%) developed new-onset atrial fibrillation during their hospitalization. Rates of new-onset atrial fibrillation (5.5% to 4.5%) and pre-existing atrial fibrillation (7.4% to 6.7%) declined during the study. Pre-existing atrial fibrillation was associated with older age and greater cardiovascular disease burden, whereas new-onset atrial fibrillation was closely related to the severity of the index acute coronary syndrome. Patients with atrial fibrillation were less likely than patients without atrial fibrillation to receive evidence-based therapies and were more likely to develop in-hospital complications, including heart failure. Overall hospital death rates in patients with new-onset and pre-existing atrial fibrillation were 14.5% and 8.9%, respectively, compared to 1.2% in those without atrial fibrillation. Short-term death rates in atrial fibrillation patients declined over the study period. Despite a reduction in the rates of, and mortality from, atrial fibrillation, this arrhythmia exerts a significant adverse effect on survival among patients hospitalized with an acute coronary syndrome. Opportunities exist to improve the identification and treatment of acute coronary syndrome patients with, or at risk for, atrial fibrillation to reduce the incidence and resultant complications of this dysrhythmia.
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影响因子：
4.8
作者：
Wong, CK;White, HD;Ohman, EM
通讯作者：
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DOI：
10.1111/j.1365-2710.2010.01167.x
发表时间：
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影响因子：
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作者：
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作者：
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