合并腹部肥胖和心房颤动高风险的患者:将纠正可改变的风险因素作为一级预防策略(前瞻性研究)

A. I. Olesin, I. V. Konstantinova, N. N. Tyuteleva, V. S. Ivanov
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引用次数: 0

摘要

目的评估纠正可改变的风险因素是否能有效预防腹型肥胖和房性早搏合并症患者的房颤。我们招募了 889 名腹部肥胖和房性早搏的合并症患者,他们的年龄在 58 岁至 72 岁之间(平均年龄为 66.4 ± 0.7 岁)。随访时间为 3 年。所有患者都接受了房颤潜在可改变风险因素的纠正(体重、血压、血糖和血脂水平正常化,戒烟,消除缺乏运动),直至达到目标值。终点包括维持窦性心律或登记房颤。随访结束后,所有患者可分为两组:578 例(65.02%)风险因素未完全纠正的患者,95 例(10.69%)达到目标值的患者,以及 216 例(24.29%)未纠正风险因素的患者。在最初两年的随访中,房颤发生率没有显著差异,分别为 85.29%、94.32% 和 93.47%。在潜在可改变风险因素达到目标值大于 1 年的患者中,随访第二年和第三年心房颤动的实际发生率与预测发生率之比分别为 57.58% 和 14.29%。在腹型肥胖和房性早搏的合并症患者中,只有在成功纠正所有潜在可改变风险因素≥2年的患者中才能观察到房颤的减少。
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Comorbid Patients with Abdominal Obesity and High Risk of Atrial Fibrillation: Correction of Modifiable Risk Factors as a Strategy of Primary Prevention (Prospective Study)
Aim. To assess whether correction of modifiable risk factors is efficient to prevent atrial fibrillation (AF) in comorbid patients with abdominal obesity and premature atrial contractions.Materials and Methods. We enrolled 889 comorbid patients with abdominal obesity and premature atrial contractions, aged from 58 to 72 years (average age 66.4 ± 0.7 years). The duration of follow-up was 3 years. All patients underwent correction of potentially modifiable risk factors of AF (normalisation of body weight, blood pressure, blood glucose and lipid levels, cessation of smoking, elimination of physical inactivity) until their target values were achieved. Endpoints included maintenance of sinus rhythm or registration of AF. After the follow-up, all patients could be divided into two groups: 578 (65.02%) patients with incomplete correction of risk factors, 95 (10.69%) patients who achieved target values, and 216 (24.29%) without risk factor correction.Results. Within the first two years of follow-up, the frequency of AF did not differ significantly and was 85.29%, 94.32%, and 93.47% respectively. In patients who achieved target values of potentially modifiable risk factors for > 1 year, the ratio of actual to predicted development of AF during the 2nd and 3rd year of follow-up was 57.58% and 14.29%, respectively.Conclusion. In comorbid patients with abdominal obesity and premature atrial contractions, reduction of AF was observed exclusively in patients with successful correction of all potentially modifiable risk factors for ≥ 2 years.
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