Jie Li, Liping Zhang, P. Chao, Xiaoyang Chen, Yong Wang
{"title":"体重波动对房颤预后的影响","authors":"Jie Li, Liping Zhang, P. Chao, Xiaoyang Chen, Yong Wang","doi":"10.3760/CMA.J.ISSN.1008-6315.2019.05.013","DOIUrl":null,"url":null,"abstract":"Objective\r\nTo investigate the effect of body mass fluctuation on the prognosis of patients with atrial fibrillation.\r\n\r\n\r\nMethods\r\nThe patients diagnosed with atrial fibrillation in the People′s Hospital of Xinjiang Uygur Autonomous Region from 2012 to 2014 were selected.Among the 540 patients, the patients were divided into normal body(BMI ≤ 25 kg/m2), overweight (25 kg/m2<BMI<30 kg/m2) and obesity (BMI ≥ 30 kg/m2) according to the baseline body mass.The median body mass fluctuation of the three groups was 2.40 kg, and according to the median body mass fluctuations, the patients were divided into two groups: the high body mass fluctuation group and the low body mass fluctuation group.Changes of body mass were observed and the incidence of cardiac death, acute coronary syndrome, chronic heart failure, cerebral embolism and peripheral vascular embolization were monitored.\r\n\r\n\r\nResults\r\nDuring the follow-up period, as the increased of body mass fluctuation, the incidence rate of end point events also increasing continuously.The main end point event was used as the composite end point (HR(95%CI): 1.03 (1.06~1.15); P=0.02), including the cardiogenic death (HR(95%CI): 1.04 (1.09~1.12); P=0.03), the incidence of acute coronary syndrome (HR(95%CI): 1.04 (0.96~1.08); P=0.06) and the heart failure incidence (HR(95%CI): 95%CI: 1.04 (1.01~1.09), P=0.04). The secondary endpoint as composite endpoint (HR(95%CI): 1.16 (1.15~1.31); P=0.01), including the cerebral embolism (HR(95%CI): 1.21 (1.23~1.54); P=0.01) and the peripheral vascular embolism (HR(95%CI): 1.03 (0.91~1.03); P=0.01). After adjusting for all confounding factors, the quartile group with the highest body mass fluctuations was 6.2% higher in the main endpoint event than the lowest body quartile and 14.2% higher in the secondary endpoint.The occurrence of major endpoint events and secondary endpoint events in the quadruple group with high body mass fluctuation was significantly higher than that in the quadruple group with the lowest body mass fluctuation(main endpoint: 4.4% vs 10.6%; (HR(95%CI): 1.86 ( 1.53 ~ 2.41); P<0.01; secondary endpoints: 15.6% vs 29.8%; (HR(95%CI) 2.12 (1.56 ~ 3.58); P<0.01). The main endpoint events were cardiogenic death (HR(95%CI): 1.85 (1.73~2.3); P<0.01); incidence of acute coronary syndrome (HR(95%CI): 1.02 (0.94~1.35); P=0.08); incidence of heart failure (HR(95%CI): 1.48 (1.28~1.62); P<0.01); secondary endpoint events were cerebral embolism (HR(95%CI): 2.23 (1.93~3.91). (P<0.01), peripheral vascular embolism (HR(95%CI): 1.05 (0.96~1.42); P=0.13). For patients with normal body mass, body mass fluctuations had no significant effect on prognosis (main endpoints: 6.1% vs 5.3%; (HR(95%CI): 1.04 (0.94 ~ 1.43); P=0.064; secondary endpoint : 16.7% vs 17.4%; (HR(95%CI): 1.12 (0.84~ 1.09); P=0.072), but for overweight and obese patients, the greater the fluctuation of body mass, the higher the incidence of adverse events (main endpoint: super-recombination: 5.8% vs 11.2%; (HR(95%CI): 1.532 (1.135 ~ 3.156); P<0.001; obese group: 8.3% vs 15.1%; (HR(95%CI): 1.584 (1.258~3.489); P<0.001; secondary end points: super recombination: 17.1% and 21.3%; (HR(95%CI): 341.00 ( 1.132~ 1.984); P=0.013; obese group: 19.4% and 25.2%; (HR(95%CI): 1.315 (1.128~2.123); P=0.018).\r\n\r\n\r\nConclusion\r\nBody mass fluctuations can significantly affect the prognosis of patients with atrial fibrillation and has a greater impact on patients with overweight and obesity.\r\n\r\n\r\nKey words: \r\nAtrial Fibrillation; Body mass; Fluctuations; Prognosis","PeriodicalId":10365,"journal":{"name":"中国综合临床","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effect of body mass fluctuation on the prognosis of atrial fibrillation\",\"authors\":\"Jie Li, Liping Zhang, P. Chao, Xiaoyang Chen, Yong Wang\",\"doi\":\"10.3760/CMA.J.ISSN.1008-6315.2019.05.013\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objective\\r\\nTo investigate the effect of body mass fluctuation on the prognosis of patients with atrial fibrillation.\\r\\n\\r\\n\\r\\nMethods\\r\\nThe patients diagnosed with atrial fibrillation in the People′s Hospital of Xinjiang Uygur Autonomous Region from 2012 to 2014 were selected.Among the 540 patients, the patients were divided into normal body(BMI ≤ 25 kg/m2), overweight (25 kg/m2<BMI<30 kg/m2) and obesity (BMI ≥ 30 kg/m2) according to the baseline body mass.The median body mass fluctuation of the three groups was 2.40 kg, and according to the median body mass fluctuations, the patients were divided into two groups: the high body mass fluctuation group and the low body mass fluctuation group.Changes of body mass were observed and the incidence of cardiac death, acute coronary syndrome, chronic heart failure, cerebral embolism and peripheral vascular embolization were monitored.\\r\\n\\r\\n\\r\\nResults\\r\\nDuring the follow-up period, as the increased of body mass fluctuation, the incidence rate of end point events also increasing continuously.The main end point event was used as the composite end point (HR(95%CI): 1.03 (1.06~1.15); P=0.02), including the cardiogenic death (HR(95%CI): 1.04 (1.09~1.12); P=0.03), the incidence of acute coronary syndrome (HR(95%CI): 1.04 (0.96~1.08); P=0.06) and the heart failure incidence (HR(95%CI): 95%CI: 1.04 (1.01~1.09), P=0.04). The secondary endpoint as composite endpoint (HR(95%CI): 1.16 (1.15~1.31); P=0.01), including the cerebral embolism (HR(95%CI): 1.21 (1.23~1.54); P=0.01) and the peripheral vascular embolism (HR(95%CI): 1.03 (0.91~1.03); P=0.01). After adjusting for all confounding factors, the quartile group with the highest body mass fluctuations was 6.2% higher in the main endpoint event than the lowest body quartile and 14.2% higher in the secondary endpoint.The occurrence of major endpoint events and secondary endpoint events in the quadruple group with high body mass fluctuation was significantly higher than that in the quadruple group with the lowest body mass fluctuation(main endpoint: 4.4% vs 10.6%; (HR(95%CI): 1.86 ( 1.53 ~ 2.41); P<0.01; secondary endpoints: 15.6% vs 29.8%; (HR(95%CI) 2.12 (1.56 ~ 3.58); P<0.01). The main endpoint events were cardiogenic death (HR(95%CI): 1.85 (1.73~2.3); P<0.01); incidence of acute coronary syndrome (HR(95%CI): 1.02 (0.94~1.35); P=0.08); incidence of heart failure (HR(95%CI): 1.48 (1.28~1.62); P<0.01); secondary endpoint events were cerebral embolism (HR(95%CI): 2.23 (1.93~3.91). (P<0.01), peripheral vascular embolism (HR(95%CI): 1.05 (0.96~1.42); P=0.13). For patients with normal body mass, body mass fluctuations had no significant effect on prognosis (main endpoints: 6.1% vs 5.3%; (HR(95%CI): 1.04 (0.94 ~ 1.43); P=0.064; secondary endpoint : 16.7% vs 17.4%; (HR(95%CI): 1.12 (0.84~ 1.09); P=0.072), but for overweight and obese patients, the greater the fluctuation of body mass, the higher the incidence of adverse events (main endpoint: super-recombination: 5.8% vs 11.2%; (HR(95%CI): 1.532 (1.135 ~ 3.156); P<0.001; obese group: 8.3% vs 15.1%; (HR(95%CI): 1.584 (1.258~3.489); P<0.001; secondary end points: super recombination: 17.1% and 21.3%; (HR(95%CI): 341.00 ( 1.132~ 1.984); P=0.013; obese group: 19.4% and 25.2%; (HR(95%CI): 1.315 (1.128~2.123); P=0.018).\\r\\n\\r\\n\\r\\nConclusion\\r\\nBody mass fluctuations can significantly affect the prognosis of patients with atrial fibrillation and has a greater impact on patients with overweight and obesity.\\r\\n\\r\\n\\r\\nKey words: \\r\\nAtrial Fibrillation; Body mass; Fluctuations; Prognosis\",\"PeriodicalId\":10365,\"journal\":{\"name\":\"中国综合临床\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2019-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"中国综合临床\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2019.05.013\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"中国综合临床","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2019.05.013","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Effect of body mass fluctuation on the prognosis of atrial fibrillation
Objective
To investigate the effect of body mass fluctuation on the prognosis of patients with atrial fibrillation.
Methods
The patients diagnosed with atrial fibrillation in the People′s Hospital of Xinjiang Uygur Autonomous Region from 2012 to 2014 were selected.Among the 540 patients, the patients were divided into normal body(BMI ≤ 25 kg/m2), overweight (25 kg/m2
期刊介绍：
Clinical Medicine of China is an academic journal organized by the Chinese Medical Association (CMA), which mainly publishes original research papers, reviews and commentaries in the field.
Clinical Medicine of China is a source journal of Peking University (2000 and 2004 editions), a core journal of Chinese science and technology, an academic journal of RCCSE China Core (Extended Edition), and has been published in Chemical Abstracts of the United States (CA), Abstracts Journal of Russia (AJ), Chinese Core Journals (Selection) Database, Chinese Science and Technology Materials Directory, Wanfang Database, China Academic Journal Database, JST Japan Science and Technology Agency Database (Japanese) (2018) and other databases.
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