急性心肌梗死住院期间新发心房颤动的危险因素分析

Risk Factors of New-Onset Atrial Fibrillation during In-Hospital Period of Acute Myocardial Infarction

目的探讨急性心肌梗死(AMI)患者住院期间新发心房颤动(AF)的危险因素。方法回顾性分析2015年1月至2018年4月武汉大学人民医院心血管内科收治的235例发生AMI且既往无AF病史并接受经皮冠状动脉介入治疗患者的临床资料,依据入院后的心电图、连续心电监测分为新发AF组和无新发AF组,比较两组患者的一般资料、入院后生化指标及经皮冠状动脉介入治疗等结果,分析影响患者住院期间新发AF的危险因素。结果 235例AMI中,新发AF 82例(34. 9%),无新发AF 153例(65. 1%)。多因素Logistic回归分析结果显示,有吸烟史(OR=0. 109,95%CI 0. 042~0. 284)、糖尿病史(OR=3. 824,95%CI 1. 133~12. 902)是新发AF的危险因素(P <0. 05)。结论吸烟史、糖尿病史是新发AF的主要危险因素,在临床上应及早发现新发AF的危险因素、及早处理以降低AMI患者的病死率并改善预后。

Objective To investigate the risk factors of new-onset atrial fibrillation(AF)during hospitalization in patients with acute myocardial infarction(AMI).Methods A retrospective analysis of 235 patients with AMI who had no history of AF and who underwent percutaneous coronary intervention in the Department of Cardiology,Renmin Hospital of Wuhan University from Jan.2015 to Apr.2018 was done.After electrocardiogram and continuous ECG monitoring,these patients were divided into a new-onset AF group and a no-new AF group.The general clinical data,post-hospital biochemical indicators and percutaneous coronary intervention were compared between the two groups.Results There were 82(34.9%)patients with new AF and 153(65.1%)patients with no new AF reported among the 235 patients with AMI.Logistic regression analysis showed that history of smoking(OR=0.019,95%CI 0.042-0.284),history of diabetes(OR=3.824,95%CI 1.133-12.902)were risk factors for new-onset AF.Conclusion History of smoking history of diabetes are the major risk factors for new-onset AF.Clinically,we should find the risk factors early to deliver early treatment to reduce mortality in patients with AMI and improve the prognosis.