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中国应用生理学杂志 ›› 2018, Vol. 34 ›› Issue (3): 209-215.doi: 10.12047/j.cjap.5625.2018.050

• 研究论文 • 上一篇    下一篇

慢性肾功能不全对中老年非瓣膜性房颤患者全因死亡、心脑血管疾病死亡及血栓终点事件的影响

王海军, 郭艳, 司全金, 王玉堂   

  1. 中国人民解放军总医院南楼心内科, 北京 100853
  • 收稿日期:2017-08-28 修回日期:2018-01-07 出版日期:2018-05-28 发布日期:2018-09-08
  • 通讯作者: 司全金,Tel:010-66876329,010-66876349,E-mail:quanjin2004@sina.com;王玉堂,E-mail:wyt301@sina.com E-mail:quanjin2004@sina.com;wyt301@sina.com
  • 基金资助:
    解放军总医院科技创新苗圃基金项目(14KMM14)

Impact of chronic renal insufficiency on all-cause death, cardiac/cerebral disease death and thromboembolic events in non-vavular atrial fibrillation patients aged over 45 years

WANG Hai-jun, GUO yan, SI Quan-jin, WANG Yu-tang   

  1. Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing 100853, China
  • Received:2017-08-28 Revised:2018-01-07 Online:2018-05-28 Published:2018-09-08
  • Supported by:
    解放军总医院科技创新苗圃基金项目(14KMM14)

摘要: 目的:探讨中老年非瓣膜性房颤患者全因死亡、心脑血管疾病死亡及血栓终点事件的危险因素及慢性肾功能不全是否为其独立危险因素。方法:纳入未应用抗凝药物的中老年非瓣膜性房颤患者825例,平均年龄为76.52±11.80岁,其中女性占18.91%,75岁以上患者占64.73%,记录基线特征及各终点事件发生情况。通过Cox生存分析,探讨肾功能不全对各终点事件的影响。结果:入选患者中位数随访时间为33.5个月,随访期间发生全因死亡209例、心脑血管疾病死亡61例及血栓终点事件139例。合并慢性肾功能不全的房颤患者各终点事件发生率均显著高于对照组,在校正CHA2DS2-VASc评分危险因素及其他传统危险因素后,慢性肾功能不全仍是全因死亡、心脑血管疾病死亡及血栓终点事件的独立危险因素。结论:慢性肾功能不全是未服用抗凝药物的中老年非瓣膜性房颤患者全因死亡、心脑血管疾病死亡及发生血栓事件的独立危险因素之一。

关键词: 心房颤动, 慢性肾功能不全, 血栓事件, 死亡

Abstract: Objective: To investigate whether chronic renal insufficiency is an independent risk factor or not for all-cause death, cardiac/cerebral disease death and thromboembolic events in patients with non-vavular atrial fibrillation aged over 45 years.Methods: Eight hundred and twenty-five non-vavular atrial fibrillation patients without anticoagulation therapy aged over 45 years were enrolled in this study. The average age of the patients was 76.52±11.80 years old, 18.91% of the patients was female, while 64.73% of the patients was over 75 years old. The baseline characteristics and adverse events during the observation period were recorded. Multivariate Cox regression analysis was adopted to calculate the adjusted hazard ratio (HR) of renal insufficiency for clinical adverse events.Results: During a median of 33.5 months' follow-up, 209 patients died of all-cause death, and 61 patients died of cardiac/cerebral disease death. A total of 139 patients had thromboembolic events (stroke or transient ischemic attack (TIA), or peripheral arterial thromboembolism). All of the adverse events were higher in atrial fibrillation patients with chronic renal insufficiency than those in control group (P<0.05). After adjustment for CHA2DS2-VASc score and other traditional risk factors, chronic renal insufficiency was also an independent predictor of the all-cause death, cardiac/cerebral disease death, thromboembolic events (P<0.05).Conclusion: After adjustment for CHA2DS2-VASc score, chronic renal insufficiency was one of the independent risk factors for all-cause death, cardiac/cerebral disease death, thromboembolic events in non-vavular atrial fibrillation patients aged over 45 years without anticoagulation therapy.

Key words: atrial fibrillation, chronic renal insufficiency, thromboembolic event, mortality

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