Effect of hypertrophic cardiomyopathy on the prediction of thromboembolism in patients with nonvalvular atrial fibrillation
Effect of hypertrophic cardiomyopathy on the prediction of thromboembolism in patients with nonvalvular atrial fibrillation
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DOI：
10.1016/j.hrthm.2018.11.029
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发表时间：
2019-06-01
期刊：
影响因子：
5.5
通讯作者：
Yamagishi, Masakazu
中科院分区：
文献类型：
--
作者：
Tsuda, Toyonobu;Hayashi, Kenshi;Yamagishi, Masakazu
背景 根据欧洲和美国指南，建议对伴有非瓣膜性心房颤动 (NVAF) 的肥厚型心肌病 (HCM) 进行抗凝治疗。然而，目前尚不清楚 HCM 是否是日本 NVAF 血栓栓塞的危险因素，并且尚未建立 HCM 合并 NVAF 的治疗方法。 目的 我们研究了合并 HCM 对预测 NVAF 血栓栓塞的影响。 方法 我们回顾性研究了连续 2374 名日本 NVAF 患者（1682 名男性，70.9%；平均年龄 71 +/- 10 岁） 年）。使用Cox比例风险模型评估临床因素。我们还研究了将 HCM 添加到 CHADS(2) 或 CHA(2)DS(2)-VASc 评分中是否可以改善血栓栓塞的预测。 结果 在中位随访 2.4 年（四分位距 2.0-3.2 年）期间，122 名患者 (5.1%) 观察到血栓栓塞。 Cox 比例风险模型显示，调整 CHADS(2) 或 CHA(2)DS(2)-VASc 评分后，HCM 与血栓栓塞显着相关（风险比 3.41；95% 置信区间 [CI] 1.98-5.73；P
BACKGROUND Anticoagulation is recommended for hypertrophic cardiomyopathy (HCM) with nonvalvular atrial fibrillation (NVAF) according to European and American guidelines. However, it is unclear whether HCM is a risk factor for thromboembolism in NVAF in Japan, and the management for NVAF with HCM is not established.OBJECTIVE We studied the impact of concomitant HCM on predicting thromboembolism in NVAF.METHODS We retrospectively studied consecutive 2374 Japanese patients with NVAF (1682 men, 70.9%; mean age 71 +/- 10 years). Clinical factors were evaluated using the Cox proportional hazards model. We also investigated whether adding HCM to CHADS(2) or CHA(2)DS(2)-VASc score improved the prediction of thromboembolism.RESULTS Thromboembolism was observed in 122 patients (5.1%) during the median follow-up of 2.4 years (interquartile range 2.0-3.2 years). The Cox proportional hazards model showed that HCM was significantly associated with thromboembolism after adjustment for CHADS(2) or CHA(2)DS(2)-VASc score (hazard ratio 3.41; 95% confidence interval [CI] 1.98-5.73; P