基于真实世界数据分析稳定型冠心病患者并发心力衰竭的危险因素

Analysis of Risk Factors for Complicated Heart Failure of Patients with Stable Coronary Heart Disease Based on Real World Data

目的基于真实世界数据分析稳定型冠心病(SCAD)患者并发心力衰竭的危险因素,以期为SCAD患者预防心力衰竭提供建议,进而减轻SCAD患者的疾病负担。方法收集2013年6月至2017年5月陕西省某二级医院SCAD患者的电子病历数据,以SCAD无心力衰竭患者为基准组,卡钳值取0.05,采用1∶1最近邻匹配法筛选出基线一致的SCAD伴心力衰竭患者作为对照组。采用Logistic回归模型分析SCAD各特殊合并症与心力衰竭发病的相关性。结果共纳入SCAD患者4 063例,倾向性评分匹配(PSM)控制基线一致后纳入SCAD患者2 556例;Logistic回归分析结果显示,糖尿病(OR=1.442,95%CI:1.077~1.930)、心房颤动(OR=2.555,95%CI:1.954~3.341)、慢性阻塞性肺疾病(OR=1.547,95%CI:1.214~1.970)是心力衰竭发病的独立危险因素。结论 SCAD伴有的糖尿病、心房颤动、慢性阻塞性肺疾病是导致心力衰竭发病的独立危险因素。

Objective To analyze the risk factors leading to heart failure(HF) among stable coronary artery disease(SCAD) patients, in order to provide the suggestion on the prevention of HF. Methods The electronic medical record data of SCAD patients in a Secondary Hospital in Shaanxi Province from June 2013 to May 2017 was collected. Took the SCAD patients without HF as the benchmark group, the caliper value was set to 0.05, and the 1:1 nearest neighbor matching method was used to screen the baseline to be consistent SCAD patients with heart failure served as a control group. Logistic regression model was used to analyze correlation between the special complications of SCAD and the onset of HF. Results A total of four thousand and sixty-three patients were included. A total of two thousand five hundred and fifty-six patients were included after using PSM to control baseline to be consistent. The logistic regression analysis showed that diabetes mellitus(OR=1.442, 95% CI:1.077-1.930), atrial fibrillation(OR=2.555, 95% CI: 1.954-3.341) and chronic obstructive pulmonary diseases(OR=1.547, 95% CI: 1.214-1.970) were independent risk factors of HF. Conclusion Diabetes, atrial fibrillation and COPD are independent risk factors of SCAD patients in progressing to HF.