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首页> 外文期刊>The American Journal of Cardiology >Influence of Atrial Fibrillation on Outcomes in Patients Who Underwent Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction
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Influence of Atrial Fibrillation on Outcomes in Patients Who Underwent Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction

机译：心房颤动对初步经皮冠状动脉介入的患者结果的影响

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摘要

Atrial fibrillation (AF) is a common co-morbidity among patients presenting with acute ST-segment elevation myocardial infarction (STEMI). Previously, small studies have reported an association between AF and poorer outcomes among patients with STEAK We performed this study to investigate the impact of AF on in-hospital outcomes in patients with STEMI treated with primary percutaneous coronary intervention (PPCI) using a large national database. The study population constituted of patients 18 years and older with a primary discharge diagnosis of STEMI and who underwent PPCI. Using a 2:1 matching protocol, matched groups of patients with AF (N = 24,680) and without (N = 49,198) were developed. Among 1,493,859 patients with STEMI who underwent PPCI, 129,354 patients (8.7%) had AF. In the propensity-matched cohort, adjusted in-hospital mortality was significantly higher for patients with AF compared with patients with no AF (10.3% vs 9.4%) (adjusted odds ratio [OR] 1.10; confidence interval [CI] 1.06 to 1.16; p 0.0001). Patients with AF were also at higher risk of heart failure, cardiogenic shock, acute stroke, acute kidney injury, vascular complications, need for blood transfusion, and a composite outcome of gastrointestinal and retroperitoneal bleeding. Patients with AF were less likely to be treated with drug-eluting stent compared with patients without AF (51.4% vs 56.6%) (adjusted OR 0.81; CI 0.79 to 0.84; p 0.001). Among patients presenting with STEMI and who underwent PPCI, AF is present in about 8% of patients. In a propensity-matched analysis using a large national database, AF was found to be independently associated with a higher risk of in-hospital mortality and of other complications in these patients. (C) 2017 Elsevier Inc. All rights reserved.
机译：心房颤动（AF）是患有急性ST段抬高心肌梗死（Stemi）的患者的常见辅助性。此前，小型研究报告了牛排患者之间的AF和较差的结果之间的关联，我们进行了这项研究，探讨了使用大型国家数据库用初级经皮冠状动脉介入（PPCI）治疗的患者的医院内结果的影响。由18岁及以上的患者组成的研究人群，其初级放电诊断诊断和接受PPCI的患者。使用2：1匹配协议，开发了AF（n = 24,680）和没有（n = 49,198）的患者匹配组。在1,493,859名患有PPCI的患者中，129,354名患者（8.7％）有AF。在倾向匹配的队列中，随着AF的AF（10.3％VS 9.4％）（调整的赔率比[或] 1.10;置信区间[CI] 1.06至1.16，AG的患者，AG的患者的患者的患者的入院性死亡率显着高得多。 P＆ 0.0001）。 AF患者也处于心力衰竭的风险较高，心肌休克，急性中风，急性肾损伤，血管并发症，需要输血，以及胃肠道和腹膜腹膜的复合结果。与无AF的患者相比，AF的患者不太可能用药物洗脱支架（51.4％Vs 56.6％）（调节或0.81; CI 0.79至0.84; P <0.001）。在患有STEMI的患者中，患者接受PPCI，AF的约8％的患者存在。在使用大型国家数据库的倾向匹配的分析中，发现AF与患者中医发生的风险和这些患者的其他并发症有独立相关。 （c）2017年Elsevier Inc.保留所有权利。

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