Staccato型和legato型心房颤动患者出院后2年内心血管事件对比分析  

Comparison in cardiovascular events between patients with Staccato atrial fibrillation and patients with legato atrial fibrillation within 2 y after discharged

作　　者：李雪燕 陈华 叶严丽 陈劲松 Li Xueyan;Chen Hua;Ye Yanli;Chen Jingsong(Department of Critical Care Medicine,Chinese PLA Joint Logistics Support Force 909th Hospital,Zhangzhou 363000,China;不详)

机构地区：[1]解放军联勤保障部队第九〇九医院重症医学科,漳州363000 [2]解放军联勤保障部队第九〇九医院心内科,漳州363000 [3]漳州正兴老年病医院老年一科,漳州363000

出　　处：《中国循证心血管医学杂志》2022年第2期210-213,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨并分析Staccato型和legato型心房颤动(房颤)患者出院后2年内心血管事件的发生情况。方法选取2016年1月至2018年12月于解放军联勤保障部队第九O九医院心内科和神经内科收治的阵发性房颤患者712例为研究对象,根据房颤发作的频次和持续时间将其分为Staccato型组(n=326)和legato型组(n=386)。分析患者出院后2年内心血管死亡、卒中、急性冠脉事件、周围动脉栓塞、心功能不全加重的发生率和转归。结果中位随访16.2个月,Staccato型组和legato型组中2年累积心血管事件发生率分别为12.9%(42/326)和18.9%(73/386)。调整混杂因素后Cox回归模型分析结果显示,与Staccato型组比较,legato型组出院后2年内心血管事件发生风险增加(HR=1.36;95%CI:1.21~1.52,P<0.05],其中心血管死亡(HR=1.38,95%CI:1.21~1.66,P=0.034)、心力衰竭加重(HR=1.21,95%CI:1.07~1.44,P=0.045)。随访显示,随病程延长,房颤发作特征倾向性于Staccato型向legato型演变。结论在阵发性房颤非规范抗凝患者中,Staccato型房颤患者较legato型房颤患者有更低心血管事件的发生率。规范抗凝有助于减少此两型阵发性房颤心血管事件风险。Objective To discuss and analyze the occurrence of cardiovascular events in patients with Staccato atrial fibrillation(SAF)or legato atrial fibrillation(LAF)within 2 y after discharged.Methods The patients with paroxysmal atrial fibrillation(PAF,n=712)were chosen from Department of Cardiology and Department of Neurology from Jan.2016 to Dec.2018.The patients were divided,according to frequency and duration of PAF attack,into SAF group(n=326)and LAF group(n=386).The incidence rates of cardiovascular death,stroke,acute coronary events,peripheral arterial embolism and aggravation of cardiac insufficiency and outcomes were analyzed within 2 y after discharged.Results he cumulative incidence rate of cardiovascular events for 2 y was 12.9%(42/326)in SAF group and 18.9%(73/386)in LAF group during median follow-up period(16.2 months).The results of Cox regression model analysis after modified confounding factors showed that the risk of cardiovascular events increased(HR=1.36,95%CI:1.21~1.52,P<0.05),including cardiovascular death(HR=1.38,95%CI:1.21~1.66,P=0.034)and aggravation of cardiac insufficiency(HR=1.21,95%CI:1.07~1.44,P=0.045)in SAF group compared with LAF group within 2 y after discharged.Conclusion The incidence rate of cardiovascular events is lower in SAF patients than that in LAF patients among PAF patient with non-standard anticoagulation,while standard anticoagulation can reduce the risk of cardiovascular events in SAF patients and LAF patients.

关 键 词：阵发性心房颤动 心血管事件 Staccato型心房颤动 legato型心房颤动 

分 类 号：R541.75[医药卫生—心血管疾病]