Relationship between metabolic syndrome and increased risk of atrial fibrillation in patients with coronary heart disease
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摘要: 目的：探讨代谢综合征（MS）与冠心病患者心房纤颤（AF）发生的关系。方法: 入选住院拟行选择性冠状动脉造影（CAG），并确诊为冠心病（CHD）的患者1 805例，分为非MS组（n=1 150）及MS组（n=655），比较两组的相关临床资料，超声心动图及AF的情况。结果: MS组患者AF发生率明显高于非MS组（14.2% vs. 8.1%，P<0.01），MS组左房内经（LAD），左室舒张末期内径（LVEDD）、左室壁厚度（LVPW），左室质量（LVM），左室质量指数（LVMI）均高于非MS组（P<0.05），左室射血分数（LVEF）明显低于非MS组（P<0.01）。Logistic回归分析显示冠心病患者发生AF的危险与年龄，左房增大、左室扩大及并发MS明显相关（OR分别为1.666、4.446、1.950、1.636，均P<0.05）。AF（n=188）与无AF患者（n=1 617）相关指标、单因素分析发现AF组MS发生率明显高于无AF组（49.3% vs. 4.5%，P<0.01），体质量指数（BMI）、空腹血糖（FPG）水平明显升高（均P<0.05）。进一步Logistic回归分析显示MS组中肥胖与AF的发生关系最密切（OR：1.911，P<0.01）。结论: MS与冠心病患者发生AF的危险关系密切。Abstract: AIM: To explore the effect of metabolic syndrome (MetS) on atrial fibrillation (AF) in coronary heart disease (CHD) patients. METHODS: A cross-sectional study was conducted in a cohort of 1805 hospitalized CHD patients who were divided into CHD+non-MetS group (n=1 150) and CHD+MetS group (n=655) according to MetS criteria. RESULTS: Incidence of AF in CHD+MetS group was higher than that in CHD+non-MetS group (14.2% vs. 8.1%, P<0.01). Left atrial diameter (LAD), left ventricular end-diastolic diameter (LVEDD), interventricular septum thickness (IVS), left ventricular posterior wall thickness (LVPW), left ventricular mass (LVM) and left ventricular mass index (LVMI) were higher in CHD+MetS group than those in CHD+non-MetS group (P<0.05), whereas left ventricular ejection fraction (LVEF) was lower (P<0.01). After adjustment for age, LAD and LVEDD, logistic regression analysis showed that MetS predicted the incidence of AF in CHD patients (OR: 1.631, P<0.05). AF patients (n=188) were more likely to be complicated with MetS than non-AF patients (n=1 617, 49.3% vs. 34.5%, P<0.01) with higher body mass index (BMI) and fasting plasma glucose (FPG)(P<0.05). Further logistic regression analysis suggested that obesity was the most closely related independent predisposing risk factor for AF (OR: 1.911, P<0.01). CONCLUSION: MetS is closely associated with the incidence of AF in CHD patients. Obesity is the most closely related predisposing factor for AF among all MetS factors.
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Keywords:
- coronary disease /
- metabolic syndrome /
- atrial fibrillation
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