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稳定性冠心病患者高敏肌钙蛋白升高者房颤风险高

2016-12-28 卢芳 中国循环杂志

冠心病患者一旦合并房颤,其死亡、心衰和卒中风险会显著增加。而重庆医科大学附属第二医院陈庆伟、唐映红等进行的研究显示,稳定性冠心病患者合并房颤并不少见,而且随着血清高敏肌钙蛋白T(hs-cTnT)水平升高,房颤风险增加。 研究者指出,在稳定性冠心病患者中监测hs-cTnT水平可能有助于识别其房颤发生风险。 这项研究共纳入1011例稳定性冠心病患者,并按基线hs-cTnT水平四分位

冠心病患者一旦合并房颤,其死亡、心衰卒中风险会显著增加。而重庆医科大学附属第二医院陈庆伟、唐映红等进行的研究显示,稳定性冠心病患者合并房颤并不少见,而且随着血清高敏肌钙蛋白Ths-cTnT)水平升高,房颤风险增加。

 

研究者指出,在稳定性冠心病患者中监测hs-cTnT水平可能有助于识别其房颤发生风险。

 

这项研究共纳入1011例稳定性冠心病患者,并按基线hs-cTnT水平四分位数分为四组:其中≤7 ng/L者共有283例患者;>7 ng/L~10 ng/L组共有238例患者;>10 ng/L~15 ng/L272例患者;>15 ng/L组有218例患者。

 

研究显示,有12.6%的患者合并房颤,而且合并房颤者比不合并房颤者,其hs-cTnT水平更高(17.0 ng/L vs 10.0 ng/L),而且,随着hs-cTnT水平的升高,其房颤风险显著增加(图1)。

 


 

研究显示,那些合并房颤的稳定性冠心病患者,年龄更大,其血清肌酐、尿酸、高敏C反应蛋白、左心房内径、左心室舒张末期内径更大。

 

在校正相关因素后,研究者发现基线最高四分位水平的hs-cTnT者其房颤发生风险,是最低四分位水平者的5.324倍。

 

研究者指出,增龄、心血管及代谢性疾病对促进心肌细胞受损及心脏结构功能改变具有协同作用,此外,左心房内径增大也是稳定性冠心病患者罹患房颤的独立预测因子。这些促成的血清hs-cTnT水平升高或反映了其中心肌的损坏以及重构等。

 

原始出处:


唐映红陈庆伟柯大智稳定性冠心病患者心房颤动与高敏肌钙蛋白的相关性研究.中国循环杂志, 2016, 31: 

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    2016-12-28 雾夜芭蕾

    房颤不好纠正

    0

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    2016-12-28 snowy900608

    对临床工作很有启示

    0

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