心房颤动患者24个月内主要心血管事件危险因素分析

Analysis of risk factors of major cardiovascular events in patients with atrial fibrillation within 24 months

目的 探讨心房颤动患者24个月内发生心血管事件的危险因素.方法 入选我院2010-03～2012-03门诊和住院治疗的心房颤动患者298例,根据患者是否在24个月内发生主要心血管事件分为两组：事件组（n=120,至少新发主要心血管事件中的一项）与无事件组（n=178,没有新发任何一项主要心血管事件）,分析两组患者的基线危险因素的特征,并随访24个月所有患者主要心血管事件的发生情况.结果 事件组患者射血分数值、吸烟、女性比例以及年龄、脉压、低密度脂蛋白、Cys-C、空腹血糖水平均显著高于无事件组（均P＜0.05）.经多因素Cox回归,年龄、女性、低射血分数是心血管事件的显著危险因素,其比值比（RR）分别为2.547（95％ CI 1.539-4.318）、1.727（95％ CI 1.418-2.732）、1.914（95％ CI 1.317-3.216）.女性、年龄和低射血分数三个危险因素预测24个月内心血管事件的ROC曲线下面积为0.633 （95％ CI0.555-0.701.P=0.005）、0.716（95％CI 0.651-0.792,P=0.000）、0.791 （95％ CI 0.682-0.805,P=0.000）.结论 年龄、女性和低射血分数是房颤患者发生新发心血管事件的显著危险因素.

Objective To explore the risk factors of major cardiovascular events in patients with atrial fibrillation within 24 months. Methods A total of 298 outpatients and inpatients with atrial fibrillation were enrolled from March 2010 to March 2012, and divided into two groups ： event group （ n = 120, at least a new cardiovascular event ） and non-event group （ n = 178, no cardiovascular events ）. The risk factors at baseline were analyzed in two groups and the occurrence of major cardiovascular events was recorded in follow-up 24 months. Results The age, pulse pressure, levels of LDL-C, Cys-C and fasting plasma glucose, ejection fraction, the proportions of female and smoking were significantly higher in event group than in non-event group. Multivariate Logistic regression analysis showed that age, female and low ejection fraction were the independent risk factors of cardiovascular events, and RR of age, female and low e- jection fraction was 2.547 （95 % CI 1. 539 - 4.318）, 1. 727 （95% CI 1. 418 - 2.732 ）, and 1. 914 （ 95% CI 1.317 - 3. 216 ）, respec- tively. Female, age and low ejection fraction had an area under the ROC curve of 0.633 （95% CI 0.555 -0.701, P = 0. 005 ） ,0.716 （ 95 % CI 0.651 - 0.792, P = 0.000 ） ,0.791 （ 95 % CI 0.682 - 0.805, P= 0.000） for predicting the occurrence of the cardiovascular e- vents in 24 months. Conclusion Age, female and low ejection fraction are the major risk factors for the occurrence of new cardiovas- cular events in patients with atrial fibrillation.