Long-term effects of simvastatin on protection against atrial fibrillation in patients with acute myocardial infarction

Objective To investigate the impact of simvastatin on blood lipid and the incidence of atrial fibrillation and ischemic-related events in patients with acute myocardial infarction accompanied by paroxysmal atrial fibrillation. Methods One hundred and three patients with acute myocardial infarction and paroxysmal atrial fibrillation were selected as subjects,and were divided into a simvastatin group and a control group. Forty-five patients were in the simvastatin group,who took simvastatin 20mg/d orally for 18 months;fifty-eight patients were in the control group,and received conventional therapy except for statins. All patients were followed up for 18 months. The level of blood lipid,recurrence rate of paroxysmal atrial fibrillation,incidence rate of persistent or permanent atrial fibrillation,and the ischemic-related events were investigated and compared between the two groups. Results ① The levels of blood lipids did not change significantly in the control group(P>0.05) ;concentrations of total cholesterol(TC) and low density lipoprotein cholesterol(LDL-C) decreased significantly after treatment of simvastatin(P<0.05) . ② Recurrence of atrial fibrillation was observed in five patients during 18 months follow-up in the simvastatin group(11.1%) ,whereas it occurred in 14 patients of the control group(24. 1%,P<0.05) ;the occurrence rate of persistent or permanent atrial fibrillation in the simvastatin group was 4.4%,which was lower than that of control(12.1%,P<0.05) . ③ Nine patients had ischemic-related events in the simvastatin group(20.0%) ,with three heart failures(6.6%) ,two rehospitalizations for deterioration of coronary heart diseases(4.4%) ,three cardiac deaths(6.6%) ,and one cerebral stroke(2.2%) ,which was lower evidently than in the control group(41.4%,P<0.05) . Conclusions Simvastatin can not only decrease the levels of serum TC and LDL-C but also prevent the occurrence of atrial fibrillation and ischemic-related events.

Influence of atrial fibrillation on acute myocardial infarction

Atrial fibrillation is an increasingly common significant arrhythmia with potentially serious outcomes. Myocardial infarction is a common consequence of atherosclerosis and coronary artery disease. When the two conditions occur together, the consequences can be compounded. This article briefly reviews some of the potentials for the relationship.

The prognostic role of high-sensitivity C-reactive protein in patients with acute myocardial infarction

1 Introduction Inflammation is one of the main mechanisms in the pathogenesis of atherosclerosis,and the interest to the evaluation of inflammatory biomarkers in coronary artery disease(CAD)has been increasing over the last decade.[1,2]Destabilization of chronic artery plaques,which leads to acute coronary syndromes,has been associated with inflammatory status.[1,3]。

Acute myocardial infarction in a patient with Wolff-Parkinson-White syndrome

It is known that the Wolff-Parkinson-White syndrome （WPW） may either mimic myocardial infarction （MI） or mask the ECG changes of MI. Thus, the diagnosis of MI coexisting with WPW is frequently difficult. Furthermore, patients with WPW occurring acute MI may be life threat- ening. Therefore, early recognition and correct treatment allows rapid restoration of normal sinus rhythm and may decrease morbidity and mortality.

Autonomic function and ventricular tachyarrhythmias during acute myocardial infarction

Most cases of sudden cardiac death are attributed to sustained ventricular tachyarrhythmias(VTs), triggered by acute coronary occlusion. Autonomic dysfunction, an important arrhythmogenic mechanism in this setting, is being actively investigated, aiming at the advent of preventive strategies. Recent experimental studies have shown vagal withdrawal after anterior myocardial infarction, coinciding with high incidence of VTs, followed by more gradual sympathetic activation coinciding with a second arrhythmia peak. This article summarizes recent knowledge on this intriguing topic, generating hypotheses that can be investigated in future experimental and clinical studies.

Effect of spironolactone on cardiac remodeling after acute myocardial infarction

BACKGROUND:Few studies have reported the effect of aldosterone receptor antagonist(ARA) on myocardial remodeling after acute myocardial infarction(AMI).This study was undertaken to investigate the preventive effect of ARA on myocardial remodeling after AMI.METHODS:A total of 616 patients who had been admitted into the CCU of the First Affiliated Hospital of Harbin Medical University from January 2008 to January 2010 were studied prospectively.Only 528 patients were observed completely,including 266 of the control group and 262 of the treatment group.There was no statistical difference in age,gender,medical history,admission situation,and treatment between the two groups(P>0.05).The preventive effects of spironolactone on cardiac remodeling,left ventricular function,renal function and blood levels of potassium were evaluated by echocardiography,serum potassium and serum creatinine at one-month and one-year follow-up.RESULTS:The echocardiography indicators such as LVESD,LVEDD,LVEF,LAD-ML and LADSI were significantly improved in the treatment group compared with the control group at one year(P<0.05).In the treatment group,LVESD,LVEDD,LVPWT,LVEF,LAD-ML and LAD-SI were more significantly improved at one year than one month(P<0.05,P=0.007 to LVEF),and in the control group LVEF was more significantly improved at one year than one month(P=0.0277).There were no significant differences in serum potassium and serum creatinine levels between the two groups.CONCLUSION:On the basis of conventional treatment,the early combination of low-dose spironolactone(20 mg/d) could inhibit cardiac remodeling at late stage and prevent heart fadure.

Acute Cerebral Infarction with Atrial Fibrillation

This case report describes the presentation,diagnosis,and management of a 68-year-old man with acute cerebral infarction accompanied with atrial fibrillation.The patient presented an acute cerebral infarction with mild tricuspid regurgitation and pulmonary hypertension one month before.This time,he again developed dizziness and slurred speech for one hour,and obvious headache.Clinical symptoms and signs,and multiple diagnostic tests,including non-contrast computed tomography(CT),CT angiography,and cerebral CT perfusion analysis,revealed a definitive diagnosis of cerebral infarction with atrial fibrillation.The patient was treated with a multidisciplinary treatment approach.This case study underscores the critical importance of swift and multidisciplinary management in cases of acute cerebral infarction.In addition,the case prompts further exploration into potential contributory factors,such as tricuspid regurgitation and pulmonary arterial hypertension;tricuspid and mitral regurgitations are associated with atrial fibrillation in patients with acute ischemic stroke regardless of the severity and subtypes of valvular regurgitation.

Influences of blood lipids on the occurrence and prognosis of hemorrhagic transformation after acute cerebral infarction: a case-control study of 732 patients

Background: To study the influence of blood lipid levels on hemorrhagic transformation(HT) and prognosis after acute cerebral infarction(ACI).Methods: Patients with ACI within 72 h of symptoms onset between January 1 st, 2015, and December 31 st, 2016, were retrospectively analyzed. Patients were divided into group A(without HT) and group B(HT). The outcomes were assessed after 3 months of disease onset using the modified Rankin Scale(m RS). An m RS score of 0–2 points indicated excellent prognosis, and an m RS score of 3–6 points indicated poor prognosis.Results: A total of 732 patients conformed to the inclusion criteria, including 628 in group A and 104 in group B. The incidence of HT was 14.2%, and the median onset time was 2 d(interquartile range, 1–7 d). The percentages of patients with large infarct size and cortex involvement in group B were 80.8% and 79.8%, respectively, which were both significantly higher than those in group A(28.7 and 33.4%, respectively). The incidence rate of atrial fibrillation(AF) in group B was significantly higher than that in group A(39.4% vs. 13.9%, P<0.001). The adjusted multivariate analysis results showed that large infarct size, cortex involvement and AF were independent risk factors of HT, while total cholesterol(TC) was a protective factor of HT(OR=0.359, 95% CI 0.136–0.944, P=0.038). With every 1 mmol/L reduction in normal TC levels, the risk of HT increased by 64.1%. The mortality and morbidity at 3 months in group B(21.2% and 76.7%, respectively) were both significantly higher than those in group A(8.0% and 42.8%, respectively). The adjusted multivariate analysis results showed that large infarct size(OR=12.178, 95% CI 5.390–27.516, P<0.001) was an independent risk factor of long-term unfavorable outcomes, whereas low-density lipoprotein cholesterol(LDL-C) was a protective factor(OR=0.538, 95% CI 0.300–0.964, P=0.037). With every 1 mmol/L reduction in normal LDL-C levels, the risk of an unfavorable outcome increased by 46.2%. Major therapies, including intravenous recombinant human tissue plasminogen activator(r TPA), intensive lipid-lowering statins and anti-platelets, were not significantly related to either HT or long-term, post-ACI poor prognosis.Conclusions: For patients with large infarct sizes, especially those with cortex involvement, AF, or lower levels of TC, the risk of HT might increase after ACI. The risk of a long-term unfavorable outcome in these patients might increase with a reduction in LDL-C.

Clinical profile and outcomes of atrial fibrillation in elderly patients with acute myocardial infarction

Background Atrial fibrillation （AF） occurs commonly in patients with acute myocardial infarction （MI） and is associated with an increased long-term mortality. This study aimed to investigate the clinical characteristics and outcomes of AF in in-hospital elderly Chinese patients with acute MI. Methods A total of 967 patients with acute MI, aged 〉65 years, were categorized on the basis of the absence or presence of AF. Patients with documented AF were classified into two subgroups： the ongoing AF group and the new-onset AF group. We retrospectively evaluated the clinical profile, in-hospital outcomes, and effects of revascularization on the incidence of AF in elderly patients with acute MI. Results AF was documented in 100 （11.53%） patients and the incidence of new-onset AF was 6.51% during hospitalization. History of old MI and cerebrovascular events were more common in patients with AF than in those without AF （P 〈0.001, P 〈0.01, respectively）. The incidence of AF was higher in patients with non-ST elevated MI （P=0.014）, inferior wall MI （P=0.004） and cardiac function of Killip class Ⅲ or Ⅳ （P=-0.008）. Patients with AF had more complication of pneumonia （P=0.003） and longer hospital stay. Left circumflex coronary artery involvement was more common in patients with AF （compared with patients without AF, P 〈0.001）. Percutaneous coronary intervention or coronary artery bypass grafting significantly decreased the incidence of new-onset AF from 7.97% to 3.82% （P=0.017）. AF depended to heart failure, increased the in-hospital mortality. Conclusions AF is common in elderly patients with acute MI and is associated with poorer clinical outcomes. Revascularization reduces the incidence of AF and thus improves the clinical outcomes in these patients.

High Killips Class as a Predictor of New-onset Atrial Fibrillation Following Acute Myocardial Infarction： Systematic Review and Meta-analysis

Background： Recent observational studies have shown that patients with higher Killips score （〉Ⅰ） have higher risk of new-onset atrial fibrillation （NOAF） following acute myocardial infarction （AMI）, while others drew a neutral conclusion. The ultimate predictive value of high Killips class on NOAF remained obscure. Methods： PubMed, Web of Science, China National Knowledge Infrastructure, and the Cochrane Controlled Trials Register Databases were searched until February 2015. Of the 3732 initially identified studies, 5 observational studies with 10,053 patients were analyzed. Results： The meta-analysis of these studies showed that higher Killips score on admission was associated with higher incidence of NOAF following AMI （odds ratio 2.29, 95% confidence intcrwd 1.96 2.67, P 〈 0.00001 ）, while no significant differences exist among individual trials （P =0.14 and I^2= 43%）. Conclusions： Killips class 〉I was associated with the higher opportunity of developing NOAF following AMI.

基于机器学习的心房颤动患者发生急性脑梗死危险因素分析及预测模型构建

目的探讨基于机器学习的心房颤动患者发生急性脑梗死的危险因素分析及预测模型构建。方法选择2021年1月至2023年12月四川大学华西医院联盟医院/成都市新都区人民医院神经内科及心内科就诊的160例心房颤动患者为研究对象,根据是否发生急性脑梗死将患者分为脑梗死组(n=14)和非脑梗死组(n=146)。通过查阅2组患者的病历资料,统计患者的性别、年龄、非阵发性房颤、饮酒、服用抗凝药物情况、吸烟、心房颤动病程、糖尿病、高血压、高脂血症、脑动脉供血不足、高同型半胱氨酸血症、CHA_(2)DS_(2)-VASc评分、纤维蛋白原(FIB)和红细胞分布宽度(RDW)等,应用单因素和多因素logistic回归分析心房颤动患者发生急性脑梗死的影响因素;采用Python 3.8.0构建XGBoost、lightGBM、logistic回归及随机森林预测模型,并通过受试者操作特征曲线下面积(AUC)进行模型性能验证,评估模型的预测效能。通过最优模型的特征重要性排序功能计算危险因素的相对重要性评分。结果单因素分析结果显示,脑梗死组与非脑梗死组患者的年龄、吸烟者占比、左心房内径增大者占比、非阵发性房颤占比、高同型半胱氨酸血症患者占比、未规范抗凝者占比、RDW、FIB和CHA_(2)DS_(2)-VASc分值比较,差异有统计学意义(P<0.05);2组患者的性别、病程、饮酒史、高血压病史、高脂血症病史、糖尿病病史、脑动脉供血不足病史及左心室射血分数比较差异无统计学意义(P>0.05)。Logistic回归模型结果显示,高龄、吸烟、左心房内径增大、非阵发性房颤、未规范抗凝、FIB偏高、RDW偏大和CHA_(2)DS_(2)-VASc分值较高是心房颤动患者并发急性脑梗死的危险因素(P<0.05)。Logistic回归模型的AUC及F1-score值均最大,为最优预测模型,lightGBM和XGBoost次之,随机森林模型的预测性能最差。采用logistic回归模型的特征重要性排序功能计算8项危险因素相对重要性评分,得到危险因素重要性排名依次为:左心房内径增大、CHA_(2)DS_(2)-VASc评分高、非阵发性房颤、未规范抗凝、高龄、RDW偏大、FIB偏高、吸烟。结论高龄、吸烟、左心房内径增大、非阵发性房颤、未规范抗凝、FIB偏高、RDW偏大和CHA_(2)DS_(2)-VASc分值较高是心房颤动患者并发急性脑梗死的危险因素,4种机器学习模型中预测性能最好的是logistic回归模型,该模型对预测心房颤动患者发生急性脑梗死有一定临床意义。

八段锦对急性心肌梗死1年后射血分数保留型心力衰竭病人心肺功能的影响

目的:探讨急性心肌梗死1年后射血分数保留型心力衰竭病人坚持6个月的八段锦训练能否延缓心脏重构,减慢心功能恶化,并提升病人的运动耐力。方法:选取冠心病急性心肌梗死后1年,心脏彩超测量左室射血分数(LVEF)≥50%,年龄35~75岁的心力衰竭病人。按随机对照原则分为对照组和锻炼组,各27例。对照组采用西医标准药物治疗,锻炼组采用八段锦联合标准药物治疗。两组入院第1周,完成心肺功能、心脏彩超、6min步行距离等指标检测。干预6个月后,再次检测病人心肺功能、心脏彩超、6min步行距离等指标。观察左心房容积指数、LVEF;心肺功能检测公斤峰值摄氧量(peakVO2/kgmax)、无氧阈下代谢当量(AT-METs)和最大代谢当量(METs)及6 min步行距离变化。结果:干预6个月后,对照组peakVO2/kgmax、AT-METs、最大METs较治疗前降低,锻炼组LVEF、peakVO2/kgmax、AT-METs、最大METs较治疗前增高,且锻炼组LVEF、peakVO2/kgmax、AT-METs、最大METs高于对照组,差异均有统计学意义(P<0.01)。干预6个月后,锻炼组6 min步行距离较干预前延长,且锻炼组长于对照组,差异均有统计学意义(P<0.001)。结论:短期八段锦锻炼未显著改善病人左心房心脏重构,可提高心肺功能及运动耐量,有助于提高生活质量。

高度房间传导阻滞对急性非ST段抬高型心肌梗死病人院内新发心房颤动的影响

目的:探讨非ST段抬高型心肌梗死(NSTEMI)病人中高度房间传导阻滞(aIAB)和院内新发心房颤动(NOAF)之间的关系。方法:连续纳入2020年9月—2022年11月就诊于睢宁县人民医院并诊断为NSTEMI,在24 h内行冠状动脉血运重建治疗的病人。所有病人在首次医疗接触时记录标准的12导联心电图。图像被放大并使用半自动卡尺进行分析并获取aIAB。入院后,采用持续心电监测记录可疑心房颤动心律,并立刻通过12导联心电图确认。结果:共纳入820例NSTEMI病人,其中81例(9.9%)NOAF病人,根据有无AF将病人分为w/o NOAF组和NOAF组。与w/o NOAF组比较,NOAF组年龄、心率、Killip分级、C反应蛋白(CRP)、超敏肌钙蛋白T(hs-TnT)、N-末端B型钠尿肽前体(NT-proBNP)、住院时间、aIAB和右冠状动脉(RCA)比例均升高,左前降支(LAD)比例和左室射血分数(LVEF)降低,差异均有统计学意义(P<0.05)。将以上危险因素进行调整后发现,年龄、心率、LAD、LVEF和aIAB是院内发生NOAF的独立危险因素。受试者工作特征(ROC)曲线结果显示,年龄和aIAB对NSTEMI病人院内NOAF有较好的预测价值。将aIAB加入到NOAF的传统模型后,重分类改善指标(NRI)和综合判别改善指数(IDI)得到显著改善(P<0.001)。结论:NSTEMI病人aIAB与较高的院内NOAF风险相关,且aIAB对NOAF具有较好的特异度和敏感度。

非瓣膜性房颤合并急性心肌梗死患者血清MIP-1α,SCUBE1表达水平及其临床诊断价值

目的 探究非瓣膜性房颤(NVAF)合并急性心肌梗死(AMI)患者血清巨噬细胞炎症蛋白-1α(MIP-1α),信号肽-CUB-表皮生长因子结构域包含蛋白1(SCUBE1)表达水平及其临床诊断价值。方法 选取2021年4月-2023年5月在北大荒集团建三江医院收治的155例NVAF患者作为观察对象(观察组),根据是否合并AMI将患者分为未合并AMI组128例与合并AMI组27例,同时选取在本院健康检查的155名人员为对照组,比较各组血清MIP-1α、SCUBE1水平。受试者工作特征(ROC)曲线分析血清MIP-1α,SCUBE1对NVAF合并AMI的诊断价值。Logistic分析影响NVAF合并AMI的因素。结果 观察组血清MIP-1α、SCUBE1水平高于对照组(P<0.05)。合并AMI组左心室射血分数(LVEF)、左心房内径(LAD)、左心室舒张末期容积(LVEDV)显著低于未合并AMI组,血清MIP-1α和,SCUBE1水平、心房颤动(以下简称房颤)卒中风险评分(CHA2DS2-VASc)高于未合并AMI组(P<0.05)。ROC曲线分析显示,血清MIP-1α、SCUBE1水平辅助诊断NVAF患者合并AMI的曲线下面积(AUC)分别是0.819(95%CI:0.728~0.910)、0.784(95%CI:0.680~0.889),二者联合预测的AUC为0.917(95%CI:0.870~0.964),优于二者单独检测(Z=1.857、2.251, P<0.05)。Logistic分析显示,MIP-1α、SCUBE1是NVAF患者合并AMI的影响因素(P<0.05)。结论 NVAF合并AMI患者血清MIP-1α、SCUBE1水平升高,二者联合检测提高了对合并AMI的诊断效能,可能是NVAF合并AMI的潜在评估指标。

Ventricular Fibrillation Caused by Traumatic Coronary Artery Dissection

Coronary artery dissection due to blunt chest trauma (traumatic coronary artery dissection [TCAD]) may heal spontaneously, and some surgeons believe that conservative or elective treat-ments are sufficient, provided that there are no progressing ischemic symptoms. However, we report a patient who experienced sudden ventricular fibrillation (VF) during initial medical care for trauma injuries. The 32-year-old woman was riding in a passenger car when an accident occurred, and was subsequently transported to our emergency department. Twelve-lead electrocardiography revealed ST segment elevation in leads II, III, and aVF, although her vital signs remained stable. Therefore, we prioritized assessing the trauma at other sites, and VF suddenly occurred. Coronary angiography was performed with repeated defibrillation and chest compressions, which resulted in recovery of spontaneous circulation. Occlusion was observed in the right coronary artery, which we treated with balloon angioplasty. However, intravascular ultrasonography (IVUS) subsequently revealed coronary artery dissection, a stent was placed, and the patient successfully recovered. Therefore, IVUS may be useful for diagnosing TCAD, and swift intervention is needed if TCAD is detected.

Recurrent myocardial infarctions with normal coronary arteries in a patient with atrial flutter: A case report

Coronary embolism secondary to atrial fibrillation can lead to myocardial infarction independently of atherosclerotic coronary arteries. We encountered a patient repeatedly tortured by atrial fibrillation who presented with recurrent myocardial infarctions with normal coronary anatomy and ischemic stroke. We were frustrated by repeated failures because of some probably inappropriate decisions.

ST段抬高型心肌梗死患者经皮冠状动脉介入治疗术后新发心房颤动的影响因素研究

目的探讨ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)术后新发心房颤动(NOAF)的影响因素,为预防STEMI患者PCI术后NOAF提供参考依据。方法选取2020年2月至2023年2月河南科技大学第一附属医院收治的512例行PCI术的STEMI患者为研究对象,所有患者PCI术后均随访1年,根据随访期间患者是否NOAF分为NOAF组(51例)和n-NOAF组(461例)。STEMI患者PCI术后NOAF的影响因素采用单因素和多因素分析,并构建预测模型分析其预测价值。结果年龄较大、SYNTAX积分较高、左心房内径较大、术后无复流、血清CRP、NT-proBNP水平较高均为STEMI患者PCI术后NOAF的独立危险因素(OR=1.621、1.840、1.611、1.772、1.603、1.732,P<0.05)。ROC曲线分析结果显示,预测模型预测STEMI患者PCI术后NOAF的曲线下面积(AUC)为0.873,敏感度为82.35%,特异度为84.60%。结论STEMI患者PCI术后NOAF的独立危险因素包括年龄较大、SYNTAX积分较高、左心房内径较大、术后无复流、血清CRP、NT-proBNP水平较高,据此构建的预测模型预测价值较好,因此临床可对有上述特征的患者进行针对性治疗或干预,以降低患者NOAF的风险。

多重标志物联合检测模型在诊断4a型急性心肌梗死中的应用

目的与单一标志物高敏肌钙蛋白T(cTnT)进行对比,初步探索多重心肌标志物[和肽素(copeptin)、cTnT和心脏型脂肪酸结合蛋白(HFABP)]联合检测模型在诊断4a型急性心肌梗死(AMI)中的应用价值。方法纳入2022年3月至12月期间在南京医科大学第一附属医院接受择期经皮冠状动脉介入治疗(PCI)且术后cTnT升高超过正常参考值上限(URL)第99百分位数的非AMI患者。根据《第四版心肌梗死通用定义》,按照术后是否出现4a型AMI将患者分为非4a型AMI组和4a型AMI组。采用化学发光免疫金纳米组装体免疫传感阵列(ciGold)测定AMI生物标志物浓度。通过受试者工作特征(ROC)曲线分析单一标志物和多重联合心肌标志物诊断模型的诊断性能,从ROC曲线获得敏感性和特异性,计算ROC曲线下面积(AUCROC)评估各自诊断价值。使用Kappa分析评估多重标志物联合检测模型与《第四版心肌梗死通用定义》诊断的一致性。结果共纳入65例患者,女性占23.1%。ROC曲线分析显示,多重联合心肌标志物诊断模型的特异性为96.5%,敏感性为92.3%,符合率为94.6%,阳性预测值为92.3%,阴性预测值为96.2%,AUCROC为0.979。cTnT模型的特异性为94.2%,敏感性为100%,符合率为95.7%,阳性预测值为100%,阴性预测值为94.9%,AUCROC为0.987。虽然多重标志物联合检测模型诊断敏感性较低(P=0.011),但具有更高的特异性(P=0.016)。两种诊断模型准确性的AUCROC差异性分析提示P>0.05,诊断准确性无明显统计学差异。Kappa分析结果表明,多重联合心肌标志物检测模型与《第四版心肌梗死通用定义》诊断4a型AMI具有高度一致性,Cohen′s Kappa系数为0.818。结论多重标志物联合检测模型与cTnT在诊断4a型AMI方面性能相近,诊断一致性高,但联合检测模型具有更高的特异性优势。

CRP和D-D对急性心肌梗死并发心房颤动的预测价值

目的探讨血清C反应蛋白(CRP)与D-二聚体(D-D)在急性心肌梗死并发心房颤动风险评估中的预测价值。方法选取2020年1月至2022年12月期间南通瑞慈医院收治的60例急性心肌梗死患者,按照是否并发心房颤动分为研究组和对照组,各30例。比较两组患者血清CRP与D-D水平。采用Logistic回归分析急性心肌梗死并发心房颤动的危险因素。结果研究组患者D-D水平明显低于对照组,CRP水平则明显升高(P<0.05)。Logistic回归分析表明,患者年龄、糖尿病、D-D和CRP与急性心肌梗死并发心房颤动存在显著关联(P<0.05)。此外,这两项指标与左心房前后均呈正相关,具有预测急性心肌梗死患者并发心房颤动的诊断价值。结论血清CRP与D-D在评估急性心肌梗死并发心房颤动发生风险中具有一定的临床价值,有利于评估患者病情的严重程度。