接受直接经皮冠状动脉介入治疗的ST段抬高型急性心肌梗死患者血尿酸与新发心房颤动的关系

The relationship between hyperuricemia and new atrial fibrillation after ST-segment elevation acute myocardial infarction

目的探讨接受直接经皮冠状动脉介入治疗(pPCI)的ST段抬高型急性心肌梗死(STEMI)患者血尿酸水平对新发心房颤动(简称房颤)的影响。方法纳入2015年1月至2017年5月我院连续收治的775例行pPCI的STEMI患者。无房颤或心房扑动病史的患者,在12导联心电图或动态心电图上发现房颤或心房扑动,或在心电监护上发现持续30 s以上的房颤或心房扑动,则认为存在新发房颤。根据是否合并新发房颤将患者分为无房颤组和房颤组,两组之间建立Logistic回归模型,确定新发房颤发生的独立危险因素。结果新发房颤发生率为15.6%(121/775)。年龄>65岁(OR 5.450,95%CI 3.427~8.668),入院时高尿酸血症(OR 4.403,95%CI 2.812~6.893)和左房直径大小(OR 1.196,95%CI 1.130~1.265)为新发房颤的独立危险因素。结论接受直接PCI的STEMI住院患者中,年龄、左房直径、高尿酸血症与新发房颤患病率增加有关。

Objective To investigate the effect of serum uric acid level on new atrial fibrillation(AF)in patients with ST-segment elevation acute myocardial infarction(STEMI)treated with primary percutaneous coronary intervention(pPCI).Methods A total of 775 STEMI patients receiving pPCI in our hospital from January 2015 to May 2017 were enrolled.Patients without a history of AF or atrial flutter were considered to have new AF if AF or atrial flutter was found on 12-lead electrocardiogram or dynamic electrocardiogram,or if AF or atrial flutter lasted for more than 30 seconds on electrocardiogram monitoring.Patients were divided into the non-AF group and the new AF group according to whether they were combined with the new AF.Logistic regression model was established between the two groups to determine the independent risk factors for the occurrence of the new AF.Results The incidence of new AF was 10.3%(80/775).Patients older than 65 years(OR 5.450,95%CI:3.427-8.668),hyperuricemia(OR 4.403,95%CI:2.812-6.893)and left atrial diameter(OR 1.196,95%CI:1.130-1.265)were independent risk factors for new AF.Conclusion Age,left atrial diameter,and hyperuricemiaare associated with increased incidence of new AF in STEMI inpatients receiving pPCI.[Chinese Journal of Cardiac Pacing and Electrophysiology,2020,34(6):545-548]