Does Atrial Fibrillation Increase the Risk of New Onset Myocardial Infarction?

doi:10.12114/j.issn.1007-9572.2022.0056

Chinese General Practice ›› 2022, Vol. 25 ›› Issue (17): 2121-2126.DOI: 10.12114/j.issn.1007-9572.2022.0056

Special Issue: 心房颤动最新文章合集；心肌梗死最新文章合集；心血管最新文章合集

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Does Atrial Fibrillation Increase the Risk of New Onset Myocardial Infarction?

1.Department of Cardiology, Tangshan Gongren Hospital, Tangshan 063000, China
2.Department of Invasive Technology, Tangshan Gongren Hospital, Tangshan 063000, China
3.Department of Neurorehabilitation, Tangshan People's Hospital, Tangshan 063000, China
4.Department of Cardiology, Kailuan General Hospital, Tangshan 063000, China

Received:2022-01-14 Revised:2022-02-24 Published:2022-03-11 Online:2022-03-11
Contact: Quanle HAN
About author:
HAO Y J, YU J, HAN Q L, et al. Does atrial fibrillation increase the risk of new onset myocardial infarction?[J]. Chinese General Practice, 2022, 25 (17) : 2121-2126.

心房颤动是否会增加新发心肌梗死发病风险？

1.063000　河北省唐山市工人医院心内科
2.063000　河北省唐山市工人医院介入科
3.063000　河北省唐山市人民医院神经康复科
4.063000　河北省唐山市，开滦总医院心内科

通讯作者: 韩全乐
作者简介:
郝玉静，于洁，韩全乐，等.心房颤动是否会增加新发心肌梗死发病风险？[J].中国全科医学，2022，25（17）：2121-2126. [www.chinagp.net] 作者贡献：郝玉静、韩全乐、毛瑞英、郁静提出研究思路，设计研究方案，进行研究命题的提出、设计；于洁、宋丽华进行国内外相关论文检索，未发现提及两者的相关性研究；于洁、毛瑞英、郁静负责数据收集，参与开滦研究人群查体，面对面填写调查表；吴寿岭负责论文数据整理与统计分析；郝玉静负责论文起草；韩全乐负责最终版本修订，对论文整体负责。
基金资助:
河北省医学科学研究重点课题(20181273)

Abstract

Abstract:

Background

Atrial fibrillation is the most obvious arrhythmia in medical practice. Atrial fibrillation has been listed as one of the eight fastest-growing causes of death since 1990. Epidemiological investigation shows that the highest incidence of atrial fibrillation is 9% in people over 65 years old and 17% in people over 80 years old; more than 60% of patients with hypertension will develop atrial fibrillation after the age of 60. Atrial fibrillation increases the risk of ischemic stroke, heart failure, chronic kidney disease, cognitive impairment and dementia, but it is unclear whether it increases the risk of new onset myocardial infarction.

Objective

To investigate whether atrial fibrillation increases the risk of new onset myocardial infarction.

Methods

From June 2006 to October 2007, 96 750 employees of Kailuan Group in Tangshan, Hebei Province (Kailuan population) were selected for the study, including 458 patients with atrial fibrillation (atrial fibrillation group) and 96 292 patients without atrial fibrillation (non atrial fibrillation group) . The general information of patients was recorded, including age, gender, personal history (smoking history, drinking history) , past medical history (hypertension, coronary heart disease, diabetes, dyslipidemia) , anthropometric parameters (weight, height, blood pressure, etc.) . Total cholesterol (TC) , triglyceride (TG) , high density lipoprotein cholesterol (HDL-C) , low density lipoprotein cholesterol (LDL-C) and fasting blood glucose (FPG) were collected. The patients were followed up every 2 years, respectively, that was from 2008 to 2009, 2010 to 2011, 2012 to 2013, 2014 to 2015, and 2016 to 2017. The median follow-up was 10 years, and the end point was new onset myocardial infarction. Multivariate Cox regression model was used to analyze the effect of atrial fibrillation on new onset myocardial infarction.

Results

(1) There were significant differences in age, body mass index (BMI) , systolic blood pressure (SBP) , LDL-C, FPG, diabetes, smoking, drinking and new onset myocardial infarction between atrial fibrillation group and non atrial fibrillation group (P<0.05) . (2) Multivariate Cox regression analysis showed that atrial fibrillation increased the risk of new onset myocardial infarction compared with non atrial fibrillation〔RR=1.841, 95%CI (1.118, 2.869) , P<0.05〕. After adjusting for age and gender (male) , atrial fibrillation increased the risk of new onset myocardial infarction compared with non atrial fibrillation〔RR=1.635, 95%CI (1.049, 2.547) , P<0.05〕, after further adjustment for BMI, SBP, LDL-C, FPG, smoking and drinking, atrial fibrillation increased the risk of new onset myocardial infarction compared with non atrial fibrillation〔RR=1.381, 95%CI (1.087, 1.573) , P<0.05〕; drinking was the protective factor of new onset myocardial infarction 〔RR=0.664, 95%CI (0.572, 0.770) , P<0.05〕.

Conclusion

Atrial fibrillation is an independent risk factor of new onset myocardial infarction.

Key words: Atrial fibrillation, Myocardial infarction, Proportional hazards models, Epidemiologic studies

摘要：

背景

心房颤动是医疗实践中症状最为明显的心律失常，心房颤动已经列入自1990年以来发病率增长最快的八大死亡原因之一。流行病学调查显示，65岁以上人群心房颤动的发生率最高可达9%，80岁以上人群最高可达17%；高血压患者到60岁以后将会有60%以上发生心房颤动。心房颤动增加了缺血性卒中、心力衰竭、慢性肾脏病、认知功能障碍及痴呆等疾病的发病风险，但是否会增加新发心肌梗死发病风险，尚不明确。

目的

探讨心房颤动是否会增加新发心肌梗死的发病风险。

方法

选取2006年6月至2007年10月河北省唐山市开滦集团职工健康查体人群（开滦研究人群）96 750例，其中心房颤动患者458例（心房颤动组），无心房颤动者96 292例（非心房颤动组）。记录受试者的一般资料，包括年龄、性别、个人史（吸烟史、饮酒史）、既往病史（高血压、冠心病、糖尿病、血脂异常），人体测量指标（体质量、身高、血压等）；收集总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、空腹血糖（FPG）。每2年随访1次，即分别在2008—2009年、2010—2011年、2012—2013年、2014—2015年和2016—2017年随访，中位随访时间为10年，随访终点事件为新发心肌梗死。采用多因素Cox回归模型分析探讨心房颤动对新发心肌梗死的影响。

结果

（1）心房颤动组和非心房颤动组年龄、体质指数（BMI）、收缩压（SBP）、LDL-C、FPG、糖尿病发生率、吸烟率、饮酒率、新发心肌梗死发生率比较，差异有统计学意义（P<0.05）；（2）多因素Cox回归模型分析结果显示：心房颤动较非心房颤动增加新发心肌梗死发病风险〔RR=1.841，95%CI（1.118，2.869），P<0.05〕，校正年龄、性别（男性）后，心房颤动较非心房颤动增加新发心肌梗死发病风险〔RR=1.635，95%CI（1.049，2.547），P<0.05〕，进一步校正BMI、SBP、LDL-C、FPG、吸烟、饮酒后，心房颤动较非心房颤动增加新发心肌梗死发病风险〔RR=1.381，95%CI（1.087，1.573），P<0.05〕；饮酒为新发心肌梗死的保护因素〔RR=0.664，95%CI（0.572，0.770），P<0.05〕。

结论

心房颤动是新发心肌梗死发病的独立危险因素。

关键词: 心房颤动, 心肌梗死, 比例危险度模型, 流行病学研究

Yujing HAO,Jie YU,Quanle HAN, et al. Does Atrial Fibrillation Increase the Risk of New Onset Myocardial Infarction?[J]. Chinese General Practice, 2022, 25(17): 2121-2126. DOI: 10.12114/j.issn.1007-9572.2022.0056.
郝玉静,于洁,韩全乐等. 心房颤动是否会增加新发心肌梗死发病风险？[J]. 中国全科医学, 2022, 25(17): 2121-2126. DOI: 10.12114/j.issn.1007-9572.2022.0056.

Figures/Tables 2

References 25

[1]	GBD 2013 Mortality and Causes of Death Collaborators. Global，regional，and national age-sex specific all-cause and cause-specific mortality for 240 causes of death，1990—2013：a systematic analysis for the Global Burden of Disease Study 2013[J]. Lancet，2015，385（9963）：117-171. DOI：10.1016/S0140-6736(14)61682-2.
[2]	PSATY B M，MANOLIO T A，KULLER L H，et al. Incidence of and risk factors for atrial fibrillation in older adults[J]. Circulation，1997，96（7）：2455-2461. DOI：10.1161/01.cir.96.7.2455.
[3]	GO A S，HYLEK E M，PHILLIPS K A，et al. Prevalence of diagnosed atrial fibrillation in adults：national implications for rhythm management and stroke prevention：the AnTicoagulation and Risk Factors in Atrial Fibrillation （ATRIA） Study[J]. JAMA，2001，285（18）：2370-2375. DOI：10.1001/jama.285.18.2370.
[4]	JENKINS L S，BRODSKY M，SCHRON E，et al. Quality of life in atrial fibrillation：the Atrial Fibrillation Follow-up Investigation of Rhythm Management （AFFIRM） study[J]. Am Heart J，2005，149（1）：112-120. DOI：10.1016/j.ahj.2004.03.065.
[5]	WOLF P A，ABBOTT R D，KANNEL W B. Atrial fibrillation as an independent risk factor for stroke：the Framingham Study[J]. Stroke，1991，22（8）：983-988. DOI：10.1161/01.str.22.8.983.
[6]	THIHALOLIPAVAN S，MORIN D P. Atrial fibrillation and congestive heart failure[J]. Heart Fail Clin，2014，10（2）：305-318. DOI：10.1016/j.hfc.2013.12.005.
[7]	TAPOI L，URECHE C，SASCAU R，et al. Atrial fibrillation and chronic kidney disease conundrum：an update[J]. J Nephrol，2019，32（6）：909-917. DOI：10.1007/s40620-019-00630-1.
[8]	BUNCH T J，WEISS J P，CRANDALL B G，et al. Atrial fibrillation is independently associated with senile，vascular，and Alzheimer's dementia[J]. Heart Rhythm，2010，7（4）：433-437. DOI：10.1016/j.hrthm.2009.12.004.
[9]	MICHNIEWICZ E，MLODAWSKA E，LOPATOWSKA P，et al. Patients with atrial fibrillation and coronary artery disease——double trouble[J]. Adv Med Sci，2018，63（1）：30-35. DOI：10.1016/j.advms.2017.06.005.
[10]	ILIA R，WEINSTEIN J M，WOLAK A，et al. Coronary thrombus in ST elevation myocardial infarction and atrial fibrillation[J]. J Thromb Thrombolysis，2013，35（1）：119-122. DOI：10.1007/s11239-012-0765-z.
[11]	PACKER D L，BARDY G H，WORLEY S J，et al. Tachycardia-induced cardiomyopathy：a reversible form of left ventricular dysfunction[J]. Am J Cardiol，1986，57（8）：563-570. DOI：10.1016/0002-9149(86)90836-2.
[12]	BOSCH N A，CIMINI J，WALKEY A J. Atrial fibrillation in the ICU[J]. Chest，2018，154（6）：1424-1434. DOI：10.1016/j.chest.2018.03.040.
[13]	SHINBANE J S，WOOD M A，JENSEN D N，et al. Tachycardia-induced cardiomyopathy：a review of animal models and clinical studies[J]. J Am Coll Cardiol，1997，29（4）：709-715. DOI：10.1016/s0735-1097(96)00592-x.
[14]	YONGJUN Q，HUANZHANG S，WENXIA Z，et al. From changes in local RAAS to structural remodeling of the left atrium：a beautiful cycle in atrial fibrillation[J]. Herz，2015，40（3）：514-520. DOI：10.1007/s00059-013-4032-7.
[15]	SUN Y. The renin-angiotensin-aldosterone system and vascular remodeling[J]. Congest Heart Fail，2002，8（1）：11-16. DOI：10.1111/j.1527-5299.2002.00723.x.
[16]	FATKIN D，KELLY R，FENELEY M P. Left atrial appendage blood velocity and thromboembolic risk in patients with atrial fibrillation[J]. J Am Coll Cardiol，1994，24（5）：1429-1430. DOI：10.1016/0735-1097(94)90133-3.
[17]	SCHRICKEL J W，LICKFETT L，LEWALTER T，et al. Incidence and predictors of silent cerebral embolism during pulmonary vein catheter ablation for atrial fibrillation[J]. Europace，2010，12（1）：52-57. DOI：10.1093/europace/eup350.
[18]	LIU G J，ZHU W Q，WANG X G，et al. Association between ablation technology and asymptomatic cerebral injury following atrial fibrillation ablation[J]. Pacing Clin Electrophysiol，2014，37（10）：1378-1391. DOI：10.1111/pace.12432.
[19]	HERRERA SIKLÓDY C，DENEKE T，HOCINI M，et al. Incidence of asymptomatic intracranial embolic events after pulmonary vein isolation：comparison of different atrial fibrillation ablation technologies in a multicenter study[J]. J Am Coll Cardiol，2011，58（7）：681-688. DOI：10.1016/j.jacc.2011.04.010.
[20]	韩全乐，毛瑞英，郁静，等. 中青年人群发生急性心肌梗死的危险因素分析[J]. 中国循环杂志，2016，31（7）：632-635. DOI：10.3969/j.issn.1000-3614.2016.07.003.
[21]	KATAOKA Y，SHAO M Y，WOLSKI K，et al. Multiple risk factor intervention and progression of coronary atherosclerosis in patients with type 2 diabetes mellitus[J]. Eur J Prev Cardiol，2013，20（2）：209-217. DOI：10.1177/2047487312437931.
[22]	WILLIAMS C L，HAYMAN L L，DANIELS S R，et al. Cardiovascular health in childhood：a statement for health professionals from the Committee on Atherosclerosis，Hypertension，and Obesity in the Young （AHOY） of the Council on Cardiovascular Disease in the Young，American Heart Association[J]. Circulation，2002，106（1）：143-160. DOI：10.1161/01.cir.0000019555.61092.9e.
[23]	TOLSTRUP J S，HVIDTFELDT U A，FLACHS E M，et al. Smoking and risk of coronary heart disease in younger，middle-aged，and older adults[J]. Am J Public Health，2014，104（1）：96-102. DOI：10.2105/AJPH.2012.301091.
[24]	NEATON J D，WENTWORTH D. Serum cholesterol，blood pressure，cigarette smoking，and death from coronary heart disease. Overall findings and differences by age for 316，099 white men. Multiple Risk Factor Intervention Trial Research Group[J]. Arch Intern Med，1992，152（1）：56-64.
[25]	BIYIK I，ERGENE O. Acute myocardial infarction associated with heavy alcohol intake in an adolescent with normal coronary arteries[J]. Cardiol Young，2006，16（2）：190-192. DOI：10.1017/s1047951106000187.

项目	心房颤动组（n=458）	非心房颤动组（n=96 292）	χ²（t）值	P值
年龄（±s，岁）	65.8±14.8	55.4±7.8	-7.202^a	<0.001
男性〔n（%）〕	332（72.5）	68 455（71.1）	0.364	0.133
BMI（±s，kg/m²）	27.6±5.4	26.2±3.2	-3.822^a	0.001
SBP（±s，mm Hg）	148±16	136±15	-6.136^a	<0.001
LDL-C（±s，mmol/L）	3.0±1.0	2.7±0.9	-3.016^a	0.013
FPG（±s，mmol/L）	6.1±2.3	5.2±1.6	-2.170^a	0.022
糖尿病〔n（%）〕	117（25.5）	12 132（12.6）	29.588	<0.001
吸烟〔n（%）〕	189（41.3）	32 411（33.6）	2.898	0.014
饮酒〔n（%）〕	109（23.8）	25 758（26.8）	1.856	0.037
新发心肌梗死〔n（%）〕	14（3.0）	1 289（1.3）	3.122	0.027

项目	心房颤动组（n=458）	非心房颤动组（n=96 292）	χ²（t）值	P值
年龄（±s，岁）	65.8±14.8	55.4±7.8	-7.202^a	<0.001
男性〔n（%）〕	332（72.5）	68 455（71.1）	0.364	0.133
BMI（±s，kg/m²）	27.6±5.4	26.2±3.2	-3.822^a	0.001
SBP（±s，mm Hg）	148±16	136±15	-6.136^a	<0.001
LDL-C（±s，mmol/L）	3.0±1.0	2.7±0.9	-3.016^a	0.013
FPG（±s，mmol/L）	6.1±2.3	5.2±1.6	-2.170^a	0.022
糖尿病〔n（%）〕	117（25.5）	12 132（12.6）	29.588	<0.001
吸烟〔n（%）〕	189（41.3）	32 411（33.6）	2.898	0.014
饮酒〔n（%）〕	109（23.8）	25 758（26.8）	1.856	0.037
新发心肌梗死〔n（%）〕	14（3.0）	1 289（1.3）	3.122	0.027

变量		β	SE	Waldχ²值	P值	RR（95%CI）
模型一
	心房颤动	0.124	0.069	15.236	<0.001	1.841（1.118，2.869）
模型二
	心房颤动	0.061	0.070	14.227	0.011	1.635（1.049，2.547）
	年龄	0.053	0.006	115.741	<0.001	1.102 （1.080，1.119）
	性别	0.953	0.008	92.029	<0.001	3.406（1.462，6.728）
模型三
	心房颤动	0.059	0.071	12.226	0.036	1.381（1.087，1.573）
	年龄	0.087	0.009	90.170	<0.001	1.091 （1.071，1.111）
	性别	1.288	0.423	9.286	0.002	3.625（1.583，8.300）
	BMI	0.059	0.015	15.209	<0.001	1.061（1.030，1.092）
	SBP	0.009	0.002	14.232	<0.001	1.009（1.004，1.014）
	LDL-C	0.129	0.038	11.402	0.001	1.138（1.056，1.226）
	FPG	0.073	0.022	11.504	0.001	1.076（1.031，1.123）
	饮酒	-0.410	0.076	29.230	<0.001	0.664（0.572，0.770）
	吸烟	0.272	0.061	19.681	<0.001	1.313（1.164，1.481）

变量		β	SE	Waldχ²值	P值	RR（95%CI）
模型一
	心房颤动	0.124	0.069	15.236	<0.001	1.841（1.118，2.869）
模型二
	心房颤动	0.061	0.070	14.227	0.011	1.635（1.049，2.547）
	年龄	0.053	0.006	115.741	<0.001	1.102 （1.080，1.119）
	性别	0.953	0.008	92.029	<0.001	3.406（1.462，6.728）
模型三
	心房颤动	0.059	0.071	12.226	0.036	1.381（1.087，1.573）
	年龄	0.087	0.009	90.170	<0.001	1.091 （1.071，1.111）
	性别	1.288	0.423	9.286	0.002	3.625（1.583，8.300）
	BMI	0.059	0.015	15.209	<0.001	1.061（1.030，1.092）
	SBP	0.009	0.002	14.232	<0.001	1.009（1.004，1.014）
	LDL-C	0.129	0.038	11.402	0.001	1.138（1.056，1.226）
	FPG	0.073	0.022	11.504	0.001	1.076（1.031，1.123）
	饮酒	-0.410	0.076	29.230	<0.001	0.664（0.572，0.770）
	吸烟	0.272	0.061	19.681	<0.001	1.313（1.164，1.481）

Does Atrial Fibrillation Increase the Risk of New Onset Myocardial Infarction?

心房颤动是否会增加新发心肌梗死发病风险？

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