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Vojnosanitetski pregled
2017, vol. 74, br. 8, str. 742-748
jezik rada: engleski
vrsta rada: izvorni naučni članak
doi:10.2298/VSP150224257V

Creative Commons License 4.0
Prediktori i ishod novonastale atrijumske fibrilacije kod bolesnika sa akutnim infarktom miokarda
aClinical Centre of Montenegro, Department of Cardiology, Podgorica, Montenegro
bUniverzitet u Beogradu, Medicinski fakultet, Institut za medicinsku statistiku i informatiku
cClinical Centre of Montenegro, Department of Radiology, Podgorica, Montenegro
dClinical Centre of Montenegro, Department of Pathology, Podgorica, Montenegro

e-adresa: mihailovukmirovic@t-com.me

Sažetak

Uvod/Cilj. Pojava atrijalne fibrilacije (AF) u akutnoj fazi infarkta miokarda (MI) može biti prediktor loše prognoze. Cilj naše studije bio je da ispitamo ovu povezanost. Metode. Ukupno, 600 bolesnika je uključeno u istraživanje i podijeljeno u dve grupe. Prva grupa je obuhvatila bolesnike sa novonastalom AF, dok je druga grupa obuhvatila bolesnika bez ove aritmije. Bolesnici sa ranije registrovanom AF isključeni bili su iz istraživanja. Ispitivana je korelacija između novonastale AF i intrahospitalnog odnosno mortaliteta u toku perioda praćenja od 48 mjeseci. Takođe, analizirani su prediktori novonastale AF. Rezultati. Novonastala AF registrovana je kod 48 (8%) bolesnika. Nezavisni prediktor novonastale AF bilo je životno doba, naročito preko 70 godina [odds ratio 2,37; confidence interval (CI) 1,23–4,58), a potom i povišeni indeks telesne mase (odds ratio 1,17; 95% CI 1,04–1,33). Bolesnici sa novonastalom AF imali su povišeni intrahospitalni mortalitet u odnosu na one bez tog poremećaja srčanog ritma, ali ova razlika nije bila statistički značajna (10,4% vs 5,6%; p = 0,179. Bolesnici sa novonastalom AF imali su povišeni mortalitet nakon perioda praćenja od 48 meseci (33,3 % vs 17,8%; p = 0,009). Veliki neželjeni kardiovaskularni događaji (major adverse cardiac and cardiovascular events – MACCE) koji obuhvataju smrt, ponovni MI, odnosno revaskularizaciju i šlog, bili su češće prisutni kod bolesnika sa novonastalom AF (52,1% vs 33,9%; p = 0,011) tokom perioda praćenja od 48 meseci. Međutim, u multivarijantnom Cox regresionom modelu novonastala AF nije identifikovana kao nezavisni prediktor mortaliteta tokom perioda praćenja od 48 meseci (HR 0.68; 95% CI 0.38–1.20; p = 0.182). Zaključak. Novonastala AF kod bolesnika sa MI bila je povezana sa povišenim mortalitetom odnosno MACCE tokom perioda praćenja od 48 meseci, ali nije bila nezavisni prediktor mortaliteta tokom ovog perioda.

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