并发心房颤动对经皮冠状动脉介入治疗效果的影响  

Effect of atrial fibrillation on clinical outcomes in patients with coronary artery disease following percutaneous coronary intervention

作　　者：乔世斌[1] 王晓[1] 聂绍平[1] 甄雷[1] 杜昕[1] 吕强[1] 康俊萍[1] 刘新民[1] 胡荣[1] 吴佳慧[1] 黎旭[1] 贾长琪[1] 董建增[1] 刘小慧[1] 马长生[1] 

机构地区：[1]首都医科大学附属北京安贞医院心内科2病房,北京100029

出　　处：《临床心血管病杂志》2011年第11期811-813,共3页Journal of Clinical Cardiology

基　　金：国家重点基础研究发展计划(973计划)项目(No:2003CB517103)

摘　　要：目的:探讨并发心房颤动(房颤)对冠心病患者经皮冠状动脉介入治疗(PCI)近期和远期临床结果的影响。方法:选择接受PCI治疗的冠心病患者3 893例,根据有无房颤分为无房颤组(A组,3 802例)和并发房颤组(B组,91例),分析房颤对冠心病患者PCI术后住院和随访期间不良心脑血管事件(MACCE)的影响。结果:A组与B组院内死亡、心肌梗死、脑卒中和再次血运重建发生率比较,差异无统计学意义;A组、B组随访时间中位数分别为535d、520d,B组MACCE发生率较A组有增高趋势(15.4%∶11.4%),主要为全因死亡率较高(5.7%∶1.7%,P=0.019),心肌梗死、脑卒中和再次血运重建发生率相当。结论:并发房颤的冠心病患者接受PCI术后的远期死亡率明显高于无房颤患者,房颤是预测PCI术后远期死亡率增高的独立危险因素。Objective：To evaluate short-and long-term outcomes following percutaneous coronary intervention（PCI） in patients with coronary artery disease complicated with atrial fibrillation（Af）.Method：From July 2003 to September 2005,we enrolled 3 893 patients with coronary artery disease undergoing PCI with（n=91） or without（n=3 802） Af and analyzed the effect of Af on in-hospital and follow-up major adverse cardiovascular and cerebrovascular events（MACCE）.Result：Patients had comparable in-hospital rates of death,myocardial infarction,stroke and revascularization between Af group and non-Af group.Patients discharged in Af group and non-Af group were followed up for 535 days and 520 days,respectively.Compared with those in the non-Af group,patients in the Af group had higher incidence of follow-up all-cause mortality（5.7% vs 1.7%,P=0.019）.Although no difference was found in the incidence of follow-up MACCE between the two groups,patients in the Af group had a trend towards higher MACCE events（15.4% vs 11.4%,P=0.245）,mainly due to higher death rate（5.7% vs 1.7%,P=0.019）.Patients in the two groups had comparable follow-up rates of myocardial infarction,stroke and repeat revascularization.Conclusion：The incidence of follow-up all-cause mortality was higher in Af group than non-Af group.Af was an independent predictor of follow-up all-cause mortality in patients with coronary artery disease following PCI.

关 键 词：心房颤动 冠状动脉疾病 经皮冠状动脉介入治疗 

分 类 号：R511.7[医药卫生—内科学]