Utility of Loneliness Status to Risk Stratification and Prediction of Recurrent Atrial Fibrillation After Catheter Ablation.

IF 3.4 3区医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Advances in Therapy Pub Date : 2024-11-22 DOI:10.1007/s12325-024-03046-x

Huaxin Sun, Wenchao Huang, Yan Luo, Shiqiang Xiong, Yan Tang, Guoshu Yang, Duan Luo, Xiaolin Zhou, Zhen Zhang, Hanxiong Liu

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Abstract

Introduction: Socioeconomic determinants are increasingly important factors in the integrated management of atrial fibrillation (AF). The impact of loneliness status on AF recurrence remains unclear.

Methods: We conducted a cohort study based on patients with AF undergoing catheter ablation from 2017 to 2022. The Chinese version of the De Jong Gierveld scale (DJGLS) for evaluating loneliness degree was used. Multivariate Cox regression was performed to identify the independent risk factors for recurrent AF. A multivariate model was used to estimate the hazard ratio (HR) with 95% confidence interval (CI) when adjusting the known risk covariates in several kinds of subgroups.

Results: Nine hundred fifty-five patients with AF and mean age > 65 years finished long-term follow-up. The AF cluster with severe/extreme loneliness tended to live alone according to DJGLS scores. Multivariate Cox regression showed that loneliness status is an independent risk factor for AF recurrence by using a multivariate model with adjustments of some covariates (moderate loneliness: HR 2.02; 95% CI 1.47-2.77, P < 0.001; severe/extreme loneliness: HR 5.28; 95% CI 3.56-7.84, P < 0.001). Survival analysis demonstrated that patients with AF with a more severe degree of loneliness are more likely to have AF recurrence in the long-term follow-up (log-rank test, P < 0.001). Restricted cubic spline (RCS) showed a mainly non-linear relationship between feeling lonely and AF recurrence (P overall < 0.001, P non-linear = 0.195). Receiver-operator characteristic curve (ROC) and time-dependent ROC curve indicated that the diagnostic value of loneliness status in predicting AF recurrence is stable and acceptable.

Conclusion: A more severe degree of loneliness was positively associated with increased risk of AF recurrence. Loneliness status showed an acceptable diagnostic value in discriminating AF recurrence as an independent tripartite variable.

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孤独状态对导管消融术后心房颤动复发的风险分层和预测作用

导言：在心房颤动（房颤）的综合管理中，社会经济因素日益成为重要因素。孤独状况对房颤复发的影响仍不明确：我们对 2017 年至 2022 年接受导管消融术的房颤患者进行了一项队列研究。采用中文版德琼-吉尔维尔德量表（DJGLS）评估孤独程度。为确定复发性房颤的独立风险因素，进行了多变量 Cox 回归。在对几种亚组中已知的风险协变量进行调整后，采用多变量模型估算出危险比（HR）及95%置信区间（CI）：955 名平均年龄大于 65 岁的房颤患者完成了长期随访。根据DJGLS评分，患有严重/极度孤独的房颤群组倾向于独居。多变量 Cox 回归显示，通过使用多变量模型并对一些协变量进行调整，孤独状态是房颤复发的独立风险因素（中度孤独：HR：2.02；95% CI 1.47-2.77，P 结论：孤独感越严重，心房颤动复发的风险越高：更严重的孤独感与房颤复发风险的增加呈正相关。作为一个独立的三方变量，孤独状态在鉴别房颤复发方面具有可接受的诊断价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in Therapy 医学-药学

CiteScore

7.20

自引率

2.60%

发文量

353

审稿时长

6-12 weeks

期刊介绍： Advances in Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Advances in Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.