急诊室胸痛患者发生急性冠状动脉综合征的风险与心房纤颤的相关性分析

Relationship between acute coronary syndrome and atrial fibrillation in emergency department patients with chest pain syndromes

目的探讨在急诊室就诊的胸痛患者存在心房纤颤(AF)是否会增加发生急性冠状动脉综合征(ACS)的风险。方法收集我院2001-07～2006-08急诊室胸痛患者的资料,分为AF组和对照组。观察是否发生ACS[急性心肌梗死(AMI)和不稳定型心绞痛(UA)]。评估发生ACS的相对危险与AF的相关性。结果共有140例AF患者和683例符合标准的对照患者入选。AMI的发生率在AF组和对照组分别为11.4%和10.8%,UA分别为16.4%和15.8%,ACS分别为27.9%和26.7%。AF患者发生ACS的相对危险没有增加:AMI1.05[95%置信区间(CI)=0.63～1.75],UA1.05(95%CI=0.6～1.7),ACS1.05(95%CI=0.78～1.04)。结论在急诊室就诊的胸痛患者中,AF与发生ACS的风险增加没有相关性。

Objective To study on whether atrial fibrillation （AF） is associated with an increased risk for acute coronary syndrome （ACS） in emergency department （ED） patients with chest pain syndromes. Methods We collected the datum of the patients with chest pain in the ED of our hospital from July 2001 to August 2006. The enrolled patients were divided in two groups： AF group and control group. Measured outcomes were ACS [ acute myocardial infarction （AMI） , and unstable angina （UA） ]. The relative risks of ACS associated with AF were evaluated. Results 140 patients with AF and 683 matched control subjects were selected. The rates of AMI in AF group and control group were 11.4% and 10.8% , respectively; those of UA were 16. 4% and 15. 8% , respectively, and those of ACS were 27. 9% and 26.7%, respectively. The relative risks of ACS did not increase in the patients with AF： AMI, 1.05 [95% confidence interval （CI） =0.63-1.75]; and UA, 1.05 （95% CI=0.6-1.7）; ACS, 1.05 （95% CI =0.78 - 1.40）. Conclusion AF of the patients with chest pain syndromes in ED is not associated with an increased risk for ACS.