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ATRIAL FIBRILLATION—EARLY MORTALITY
In the March 6, 2007 issue of the Journal of the
American College of Cardiology, researchers reported
that people diagnosed for the first-time with atrial fibrillation
(AF) have a significantly greater early mortality
risk from stroke and heart failure plus morbidity risk of
cognitive impairment–especially in the elderly.
Dr. Teresa M. Tsang and colleagues, Mayo Clinic,
Rochester, MN claim that AF is a growing public health
problem, but that little has been known about the overall
mortality trends of these patients after diagnosis.
During their investigation they studied 4,618 Minnesota
residents who had their first atrial fibrillation confirmed
between 1980 and 2000. The average age of the patients
was 73 years. A total of 3,085 subjects died during
five years of follow up.
Tsang, et al found that mortality was high shortly
after diagnosis. Compared with controls without atrial
fibrillation, those with AF had a greater than 9-fold increased
hazard of death within the first four months
after diagnosis. Underwriters should note, however,
that after four months, the risk fell significantly.
The study found several factors strongly associated
with death in atrial fibrillation patients including
faster heart rate at diagnosis, being thin, history of
chronic kidney disease, and malignancy. Atrial fibrillation
"was probably not the primary cause of death in
the majority of patients but a result of an underlying
cascade of pathologic changes and events to which
conventional atrial fibrillation treatment would not make
a positive impact."
"Obviously, it is very disturbing that survival in
these patients had not improved over the last two decades,
despite multiple advances in the treatment of this
arrhythmia," Tsang commented to Reuters Health.
"However, the impact on the mortality trend was likely
multifactorial and complex. … Studies are warranted
to determine the factors that lead to and perpetuate
atrial fibrillation and prevention of these antecedent
factors, as well as the very first episode of atrial fibrillation,
may be critical in the control of this public health
problem and its consequences."
[ 此贴被tmslu在2009-08-03 11:19重新编辑 ]
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Posted: 2009-07-17 11:37 |
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