心房颤动高CHA2DS2-VASc评分≥75岁住院患者随访1年结果分析  

Analysis of one-year follow-up results of≥75-year-old atrial fibrillation inpatients with high CHA2DS2-VASc score

作　　者：张芳[1] 张伊超 贾辛未[1] 李建龙 陈春红[1] Zhang Fang;Zhang Yichao;Jia Xinwei;Li Jianlong;Chen Chunhong(Department of Cardiology,Affiliated Hospital of Hebei University,Baoding 071000,China)

机构地区：[1]河北大学附属医院心内科,河北保定071000

出　　处：《临床荟萃》2023年第2期117-120,共4页Clinical Focus

基　　金：河北省保定市科学技术项目伴或不伴房颤老年高CHA2DS2-VASc评分患者内皮功能的研究(2041ZF317)。

摘　　要：目的心房颤动(atrial fibrillation,AF)是一种常见的心律失常,随着年龄增加,致缺血性卒中风险也增加。本研究拟通过前瞻性随访≥75岁高CHA2DS2-VASc评分患者,探讨影响其预后的危险因素。方法本研究入选2015年12月至2017年11月河北大学附属医院心内科住院高CHA2DS2-VASc评分老年(≥75岁)患者196例,分为AF组和非AF组,其中AF组90例,非AF组106例。随访1年,主要终点事件为全因死亡,心力衰竭、缺血性脑卒中。采用SPSS 19.0统计软件进行数据分析。结果①全因死亡患者31例(15.8%),AF组比非AF组全因死亡、脑卒中、心力衰竭发生率均高,差异有统计学意义(P<0.05)。②年龄、既往心力衰竭为≥75岁高CHA2DS2-VASc评分患者随访1年死亡、心力衰竭的独立危险因素。③女性、高血压病为≥75岁高CHA2DS2-VASc评分患者随访1年脑卒中的独立危险因素。结论本研究显示≥75岁高CHA2DS2-VASc评分患者预后差,合并AF患者预后更差。性别、年龄是评估该类患者预后的独立危险因素。心力衰竭作为独立的危险因素,所占权重大,积极控制可明显改善预后,为目前临床上这类患者的抗凝治疗提供一定的理论依据。Objective Atrial fibrillation(AF)is a common arrhythmia that increases the risk of ischemic stroke with age.It is a prospective study to analyze the prognosis of≥75-year-old AF patients with high CHA2DS2-VASc scores,and to explore the risk factors.Methods A total of 196 elderly patients older than 75 years with high CHA2DS2-VASc scores who were hospitalized in the Department of Cardiology,Affilated Hospital of Hebei University,from December 2015 to November 2017 were recruited,including 90 in the AF group and 106 in the non-AF group.A 1-year follow-up was performed,the primary endpoint events of all-cause death,heart failure(HF),and ischemic stroke were recorded.Data processing was performed using the SPSS19.0 statistical software package.Results①There were 31 deaths(15.8%)at 1-year follow-up.The incidence of all-cause death,stroke and HF in AF group was significantly higher than that in non-AF group(P<0.05).②Age and history of heart failure were independent risk factors for death and HF in elderly patients older than 75 years with high CHA2DS2-VASc scores.③Female gender and hypertension were independent risk factors for stroke at 1-year follow-up in elderly patients older than 75 years with high CHA2DS2-VASc scores.Conclusion Elderly patients(≥75 years old)with high CHA2DS2-VASc scores have a poor prognosis,and those combined with AF have a worse prognosis.Sex and age are the independent risk factors for assessing the prognosis.As an independent risk factor,HF has a significant power,and active control can significantly improve the prognosis.Our prospective and observational study provides some theoretical basis for the current clinical treatment of such patients.

关 键 词：心房颤动 卒中 死亡 心力衰竭 高龄 

分 类 号：R541.75[医药卫生—心血管疾病]