急性心肌梗死病人新发心房颤动的危险因素分析

目的分析急性心肌梗死病人新发心房颤动的危险因素。方法选取山西省心血管病医院病人数据库中急性心肌梗死合并新发心房颤动病人64例及同期急性心肌梗死无心房颤动病人64例,比较两组临床资料差异,采用回归分析及受试者工作特征曲线(ROC)分析急性心肌梗死病人发生新发心房颤动的危险因素。结果脑钠肽、左心房内径及冠状动脉内植入支架数量均为急性心肌梗死后心房颤动发生的独立危险因素。ROC曲线提示:脑钠肽最佳截断值为513 pg/mL、左心房内径42.5 mm、植入支架2.7个可预测急性心肌梗死心房颤动发生。结论脑钠肽、左心房内径及冠状动脉内支架数量是急性心肌梗死后心房颤动的预测因素,可为临床工作提供指导。     

急性心肌梗死患者新发心房颤动的危险因素及预后分析

目的评估急性心肌梗死(AMI)患者新发心房颤动(NOAF)的危险因素,并分析其预后。方法对2017年6月至2018年6月于吉林大学第一医院就诊的435例AMI患者进行分析。NOAF定义为入院时或住院期间心电图上检测到的心房颤动。收集患者的人口统计学、临床、实验室、超声心动图和冠状动脉造影数据。采用多变量逻辑回归分析确定AMI患者NOAF和总死亡率的独立危险因素。结果在435例AMI患者中,有46例NOAF,发生率为10.6%。多变量分析显示,年龄>60岁(OR=1.072,95%CI:1.013～1.124,P=0.025)、左心室射血分数≤40%(OR=4.895,95%CI:1.826～13.605,P=0.004)和左心房直径>40 mm(OR=1.141,95%CI:1.037～1.261,P=0.012)是AMI患者NOAF的独立危险因素。当综合评估住院和随访死亡率(总死亡率)时,NOAF与预后较差相关(15.2%比7.7%,χ~2=4.925,P=0.011)。多变量分析显示,年龄>60岁、糖尿病病史、NOAF和心功能Killip分级Ⅲ/Ⅳ级均为AMI患者总死亡率的独立危险因素(均为P<0.05)。结论老年、左心室收缩功能不全和左心房直径增大是AMI患者NOAF的危险因素,出现NOAF的AMI患者预后较差。     

系统免疫炎症指数对急性心肌梗死患者新发房颤的预测效能

目的 探讨系统免疫炎症指数（SII）对急性心肌梗死（AMI）患者新发房颤（NOAF）的影响,并分析其预测效能。方法 选择无房颤（AF）病史的AMI患者234例,根据入院后是否出现NOAF分为NOAF组27例和非NOAF组207例。比较两组SII,并采用多因素Logistic回归分析确定SII对AMI患者并发NOAF的影响。绘制SII预测AMI患者并发NOAF的受试者工作特征（ROC）曲线,分析曲线下面积（AUC）、敏感度和特异度。结果 NOAF组和非NOAF组SII分别为1 580.7(984.5,2 387.0)、976.2(571.0,1 407.1),两组比较P<0.01。多因素Logistic逐步回归分析结果显示,SII(OR=1.001,95%CI:1.001～1.002,P<0.01)是AMI患者发生NOAF的独立危险因素。ROC曲线分析结果显示,SII预测AMI患者发生NOAF的AUC为0.72(95%CI:0.613～0.826,P<0.01),敏感度为0.667,特异度为0.715,最佳截断值为1 332.86。结论 SII升高是AMI患者发生NOA...     

急性心肌梗死患者住院期间新发心房颤动的危险因素研究

背景 急性心肌梗死(AMI)是新发心房颤动(NOAF)的急性病因,而NOAF又可导致AMI病情恶化.因此,明确AMI患者NOAF的危险因素并早期干预对改善患者预后、降低病死率具有积极意义.目的 探讨AMI患者住院期间NOAF的危险因素,以期能早期识别伴有高危心房颤动的AMI患者.方法 本研究为回顾性研究.选取2014-...     

急性心肌梗死并发心室颤动的危险因素及监护

为了总结急性心肌梗死(AMI)并发心室颤动的危险因素,本文对40例患者疾病过程进行了回顾分析,强调加强AMI后早期监护、密切观察并及时消除容易促发心室颤动的室性期前收缩、预防诱发因素是该类患者的监护重点。     

NT-proBNP对急性心肌梗死患者新发房颤的预测价值研究

目的探讨N末端B型脑利钠肽前体(NT-proBNP)对急性心肌梗死患者新发房颤的预测价值。方法从2008年1月至2010年12月收住我院心脏监护室的患者中入选急性心肌梗死(AMI)患者293例,按照患者住院期间是否出现房颤(AF)分为房颤组(n=43)和非房颤组(n=250)。比较两组间差异,分析血浆NT-proBNP水平对新发房颤的预测价值。结果 (1)AMI患者住院期间出现新发房颤的比例为14.7%;(2)房颤组患者NT-proBNP水平明显高于非房颤患者,且平均年龄较大,左心室射血分数、血红蛋白含量和肾小球滤过率(eGFR)均低于非房颤组;(3)多因素Logistic回归分析显示NT-proBNP可独立预测急性心肌梗死患者新发房颤(OR4.918,95%CI1.662-14.549,P=0.004)。结论血浆NT-proBNP水平可独立预测急性心肌梗死患者新发房颤的发生,可用于患者危险分层及指导早期预防治疗。     

急性心肌梗死并发房颤与冠状动脉病变及心力衰竭发生率关系探讨

目的 探讨急性心肌梗死(AMI)并发房颤与冠状动脉病变及心力衰竭发生率的关系。方法226例AMI在发病连续7天心电监护中，30例新出现房颤为房颤组，选择同期30例无房颤的AMI病人为非房颤组。根据房颤发生的时间又将房颤组30例病人分为房颤早发组(16例，房颤发生于AMI发病24小时内)和房颤迟发组(14例，房颤发生在AMI发病24小时后)，比较房颤组与非房颤组及房颤早发组、迟发组间冠状动脉造影检查结果、心力衰竭发生率的差异。结果房颤组与非房颤组比较，房颤组冠状动脉多支病变发生率高，并发心力衰竭也明显高于非房颤组。房颤早发组与迟发组比较，房颤早发组梗死相关动脉以右冠状动脉近端阻塞为主，而房颤迟发组梗死相关动脉以左冠状动脉前降支阻塞为多。结论AMI并发房颤的患者有严重的冠状动脉病变，心肌梗死后房颤出现的时间与梗死相关冠状动脉有关。AMI并发房颤，心力衰竭的发生率明显增加。     

老年急性心肌梗死患者并发心力衰竭的危险因素及预后分析

目的 探讨老年急性心肌梗死患者并发心力衰竭的危险因素及预后。方法 回顾性收集2020年1月至2022年12月常州市第一人民医院收治的老年急性心肌梗死患者158例,根据患者是否并发心力衰竭,将患者分为心力衰竭组(71例)和对照组(87例),比较2组患者临床特征,使用多因素logistics回归分析老年急性心肌梗死患者并发心力衰竭的危险因素,并分析2组患者预后差异。结果 2组患者年龄≥80岁、糖尿病、梗死部位、心房颤动、心律失常比较,差异有统计学意义(P<0.01);2组性别、体质量指数、N末端B型钠尿肽前体、左心室射血分数、颈动脉内膜中层厚度、高血压、高脂血症、吸烟、嗜酒、梗死类型以及支架置入术比较,差异无统计学意义(P>0.05)。多因素logistics回归分析显示,年龄≥80岁(OR=2.261,95%CI:1.024～4.992,P=0.043)、糖尿病(OR=2.339,95%CI:1.150～4.755,P=0.019)、前壁心肌梗死(OR=2.461,95%CI:1.092～5.546,P=0.030)、心房颤动(OR=3.241,95%CI:1.080～9.7...     

急性心肌梗死后的新发心房颤动及相关因素分析

目的探讨影响急性心肌梗死(AMI)后新发心房颤动(简称房颤)的危险因素。方法收集2013年2月至2014年10月间心内科住院首次诊断为AMI患者共376例,根据心律情况分为窦性心律(简称窦律)组和房颤组。对其临床特征进行对比,并进行Logistic多因素回归分析。结果 376例AMI患者中,新发房颤46例,与窦律组比较,房颤组年龄更大,脑利钠肽前体、高敏C反应蛋白(hs-CRP)、肌钙蛋白峰值、TIMI评分、Killip分级更高,Logistic多因素回归分析显示:hs-CRP(OR值:3.429、95%CI:1.384~8.496、P=0.008)、肌钙蛋白峰值(OR值:1.014、95%CI:1.003~1.024、P=0.010)和TIMI评分(OR值:1.251、95%CI:1.020~1.534、P=0.031)与新发房颤相关。结论 hs-CRP、肌钙蛋白峰值、TIMI评分为影响AMI后新发房颤的独立危险因素。     

急性心肌梗死患者住院期间新发心房颤动危险因素分析及预测模型的建立

目的:基于单中心数据探寻急性心肌梗死(AMI)患者新发心房颤动(房颤)的危险因素,建立列线图预测模型.方法:回顾性收集2016年1月-2019年12月因AMI住院的744例患者的临床资料,排除既往有房颤病史患者,根据住院期间是否出现新发房颤将患者分为新发房颤组(76例)和对照组(668例),通过单因素、多因素logis...     

Risk factors and prognoses analysis of new-onset atrial fibrillation in patients with acute myocardial infarction

<正>Objective To explore the risk factors and prognoses of new-onset atrial fibrillation (NOAF) in patients with acute myocardial infarction (AMI). Methods A total of468 patients with AMI were admitted into Beijing Anzhen Hospital for emergency percutaneous coronary interven-     

急性心肌梗死并心房纤颤的危险因子及预后

目的 :探讨急性心肌梗死 （AMI）并发心房纤颤 （房颤 ）的危险因子及房颤对 AMI预后的影响。方法 :比较 412例 AMI患者中并发房颤者与不并发房颤者的临床特征、住院其它并发症以及住院病死率。结果 :并发房颤组较不并发房颤组年龄大 ,肌酸磷酸激酶 （CPK）峰值高 ,左房内径大 ,入院时心功能差 ,但 L ogistic回归分析仅显示 CPK峰值、左房内径相差明显。并发房颤者病死率较无房颤者高 ,校正其它因素后仍明显。结论 :AMI并房颤者 CPK峰值高、左房内径大 ,住院病死率高 ,对该亚组应更积极的治疗。     

Changing axis deviation with changing bundle branch block and new-onset of atrial fibrillation during acute myocardial infarction

Paroxysmal atrial fibrillation is considered a frequent complication of acute myocardial infarction.It has been rarely reported alternating right and left bundle branch block associated with atrial fibrillation. It has also been rarely reported changing axis deviation with left bundle branch block also during atrial fibrillation and acute myocardial infarction. We present a case of changing axis deviation with changing bundle branch block and new-onset of atrial fibrillation in a 96-year-old Italian man with acute myocardial infarction.     

Relation of C-reactive protein and new-onset atrial fibrillation in patients with acute myocardial infarction

Recent studies have implicated systemic inflammation in the genesis and maintenance of atrial fibrillation (AF). A robust inflammatory response is an integral component of the response to tissue injury during acute myocardial infarction (AMI). However, there is no information concerning the association between inflammation and AF in patients with AMI. We studied 1,209 patients admitted for AMI. C-reactive protein (CRP) was measured by a high-sensitivity assay within 12 to 24 hours after symptom onset. The relation between CRP and new-onset AF occurring during the hospital course and at 1 year was analyzed using multivariable logistic regression and Cox models, respectively. New-onset AF during hospitalization occurred in 6.5%, 10.4%, and 17.1% of patients in the first, second and third CRP tertiles, respectively (p trend <0.0001). In a multivariable logistic regression, adjusting for clinical variables and ejection fraction, compared with patients in the first CRP tertile, the odds ratios for AF were 1.5 (95% confidence interval 0.9 to 2.5, p = 0.15) and 2.0 (95% confidence interval 1.2 to 3.3, p = 0.008) in patients in the second and third CRP tertiles, respectively (p for trend = 0.007). In a Cox multivariate analysis, CRP remained an independent predictor of new-onset AF at 1 year. In conclusion, in a large cohort of patients with AMI, there was a graded positive association between increased CRP and new-onset AF. Inflammation may contribute to the development of AF in the setting of AMI.     

永久起搏器置入术后新发心房颤动的影响因素及预后分析

目的:分析永久起搏器术后新发心房颤动的影响因素及临床预后。方法:回顾性分析于2010年1月到2012年12月期间,在北京安贞医院行双腔起搏器置入术的患者,对其长期随访。随访终点包括是否发生新发心房颤动和主要心脑血管不良事件。结果:共入选198例患者,42例(21.2%)在随访过程中检测到新发心房颤动,平均25.12个月,范围3~47个月,新发心房颤动患者的CHADS2评分[(2.05±1.08)vs.(1.28±1.12),P0.001]和CHA_2DS_2-VASc评分[(3.59±1.54)vs.(2.74±1.44),P=0.001]显著高于未发生新发心房颤动患者,Cox回归分析显示,影响患者新发心房颤动的相关因素主要是年龄(P=0.005)、左心房增大(P=0.002)。Kaplan-Meier生存分析显示,新发心房颤动组的心力衰竭住院率(RR=4.697,P=0.005)、脑卒中发生率(RR=5.114,P=0.033)高于未发生新发心房颤动组。结论:年龄和左心房扩大是永久起搏器置入患者术后新发心房颤动的相关因素,新发心房颤动可增加患者的心力衰竭和脑卒中发生风险。     

Cardiac care unit admission criteria for suspected acute myocardial infarction in new-onset atrial fibrillation

Management of new-onset atrial fibrillation (AF) varies between institutions and individual physicians. Because AF often occurs in elderly patients and is associated with coronary artery disease, patients presenting for the first time are often selected for admission to the coronary care unit to exclude the possibility of acute myocardial infarction (AMI). A review of 245 patients with AF admitted to an intensive care unit revealed 45 cases that were of new onset. AMI was diagnosed in 5 (11%) on the basis of elevated serum creatine kinase-MB levels. Evaluation of 56 clinical variables available during initial assessment indicated that infarction patients could be distinguished from others by the presence of left ventricular hypertrophy (p less than 0.01), electrocardiographic evidence of old myocardial infarction (p less than 0.01), typical cardiac chest pain (p less than 0.01), and duration of cardiac symptoms less than 4 hours (p less than 0.05). The presence of 2 or more of these features identified all AMI patients and 7 others at high risk for serious cardiac complications. The findings indicate that new-onset AF in the absence of clinical predictors suggesting myocardial ischemia or AMI does not warrant routine admission to the coronary care unit.