心率失常动荡的有用性来预测高风险患者急性心肌梗死和左室功能不全(从EPHESUS研究)心血管死亡率

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所属分类:疗效
摘要

心脏心率震荡(HRT)是急性心肌梗死(AMI)后死亡的风险有前途的标记。我们研究了HRT的风险stratifi …

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心率失常动荡的有用性来预测高风险患者急性心肌梗死和左室功能不全(从EPHESUS研究)心血管死亡率

心率紊乱(HRT)是急性心肌梗死后死亡率的风险的有希望的标记(AMI) 。我们研究了HRT对高危患者的危险分层心梗后。 HRT从24小时动态心电图监测481名住院患者心梗后心脏衰竭和/或左心功能不全的糖尿病在依普利酮后急性心肌梗死心衰疗效和生存研究(EPHESUS)随机分组前。在1年的随访,55死亡,心血管疾病49。 HRT发作(TO)和斜率(TS)是用以前和队列优化分割点和他们的心血管死亡风险独立的贡献来确定计算。模型用测试<5 ventricular premature complexes (PVCs) categorized as normal (n = 452) and with <5 VPCs excluded (n = 342). In EPHESUS, optimal cutpoints were TS ≤3.0 and TO ≥0.0. The strongest model for predicting cardiovascular mortality used EPHESUS cutpoints excluding subjects with <5 VPCs. On 3-category HRT model multivariate analysis (TS and TO normal, TS or TO abnormal, TS and TO abnormal), both TS and TO abnormal (relative risk 3.64, 95% confidence interval 1.55 to 8.55, p = 0.003) and left ventricular ejection fraction ≤30% (relative risk 1.97, 95% confidence interval 1.04 to 3.73, p = 0.037) independently predicted cardiovascular death. In conclusion, HRT is an independent predictor of cardiovascular death in a high-risk population after AMI, with a possibly higher optimal cutpoint for HRT slope than previously reported.

本研究支持在部分by在辉瑞制药,纽约,纽约的资助。

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