Acute myocardial infarction in patients with atrial fibrillation with a CHA2DS2-VASc score of 0 or 1: A nationwide cohort study

被引：53
作者：
Chao, Tze-Fan [1 ,2 ,3 ]
Huang, Yen-Chang [4 ]
Liu, Chia-Jen [5 ,6 ,7 ]
Chen, Su-Jung [6 ,7 ,8 ]
Wang, Kang-Ling [1 ,2 ,3 ]
Lin, Yenn-Jiang [1 ,2 ,3 ]
Chang, Shih-Lin [1 ,2 ,3 ]
Lo, Li-Wei [1 ,2 ,3 ]
Hu, Yu-Feng [1 ,2 ,3 ]
Tuan, Ta-Chuan [1 ,2 ,3 ]
Chen, Tzeng-Ji [9 ]
Hsieh, Ming-Hsiung [10 ]
Lip, Gregory Y. H. [11 ]
Chen, Shih-Ann [1 ,2 ,3 ]
机构：
[1] Taipei Vet Gen Hosp, Dept Med, Div Cardiol, Taipei 112, NA, Taiwan
[2] Natl Yang Ming Univ, Inst Clin Med, Taipei 112, Taiwan
[3] Natl Yang Ming Univ, Cardiovasc Res Ctr, Taipei 112, Taiwan
[4] Taipei City Hosp, Dept Med, Taipei, Taiwan
[5] Taipei Vet Gen Hosp, Dept Med, Div Hematol & Oncol, Taipei 112, NA, Taiwan
[6] Natl Yang Ming Univ, Inst Publ Hlth, Taipei 112, Taiwan
[7] Natl Yang Ming Univ, Sch Med, Taipei 112, Taiwan
[8] Taipei Vet Gen Hosp, Dept Med, Div Infect Dis, Taipei 112, NA, Taiwan
[9] Taipei Vet Gen Hosp, Dept Family Med, Taipei 112, NA, Taiwan
[10] Taipei Med Univ, Dept Med, Div Cardiol, Taipei, Taiwan
[11] Univ Birmingham, Ctr Cardiovasc Sci, City Hosp, Birmingham, W Midlands, England
来源：
HEART RHYTHM | 2014年 / 11卷 / 11期
关键词：
Atrial fibrillation; Myocardial infarction; CHA(2)DS(2)-VASc score; Subclinical atherosclerosis; Gender; 30-YEAR FOLLOW-UP; CARDIOVASCULAR-DISEASE; RISK-FACTOR; ATHEROSCLEROSIS; ASSOCIATION; GUIDELINES; STROKE;
D O I：
10.1016/j.hrthm.2014.08.003
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
BACKGROUND The risk of acute myocardial infarction (AMI) in patients with atrial fibrillation (AF) with a CHA(2)DS(2)-VASc score of 0 (for men) or 1 (for women) has not been previously investigated. OBJECTIVE The objective of the present study was to compare the risk of AMI in AF and non-AF subjects with a Low (0 or 1) CHA(2)DS(2)VASc score. METHODS By using the National Health Insurance Research Database in Taiwan, we identified 7254 men with AF (with a CHA(2)DS(2)VASc score of 0) and 4860 women with AF (with a CHA(2)DS(2)-VASc score of 1). For each study patient, 1 age-, sex-, and CHA(2)DS(2)-VASc score-matched subject without AF was randomly selected to constitute the control group (n = 12,114). The clinical end point was the occurrence of AMI. RESULTS During a mean follow-up period of 5.7 L- 3.6 years, 258 patients (1.1%) suffered an AMI, with an annual incidence of 0.29% and 0.100/0 for patients with and without AF. AF was an independent risk factor of AMI, with an adjusted hazard ratio (HR) of 2.93 (95% confidence interval 2.21-3.87; P <.001). The risk of AMI was higher in men with AF than in women with AF, with a hazard ratio of 2.24 (95% confidence interval 1.61-3.11; P <.001) after adjustment for age and other comorbidities. CONCLUSION In patients with a CHA(2)DS(2)-VASc score of 0 or 1, AF was an independent risk factor of AMI. The risk of AMI was higher in men with AF than in women with AF. Cardiovascular risk prevention should be performed as part of the holistic management of AF to minimize the risks of AMI associated with AF.
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页码：1941 / 1947
页数：7
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