贫血对心房颤动患者心血管不良事件的影响研究进展
Advances in adverse cardiovascular events in patients with anemia and atrial fibrillation
张筑欣 1姚焰1
作者信息
- 1. 100037 北京市,中国医学科学院阜外医院心律失常一病区国家心血管病中心北京协和医学院
- 折叠
摘要
贫血定义为血红蛋白浓度或血细胞比容值降低,患病人数约占世界总人口的近四分之一,特别是在老年人群及患有其他慢性疾病的人群中更为常见(如心力衰竭、糖尿病等).心房颤动(简称房颤)是临床上最常见的心律失常,其发病风险随着年龄增长而上升,目前,全球房颤患病率约为0.5％,预计随着人口老龄化,在未来五十年将会有显著增长.房颤增加了心源性血栓栓塞和死亡的风险,而口服抗凝药虽然可以减少血栓形成风险,却以提高出血风险为代价.当前,贫血已被确认为房颤患者在接受抗凝治疗时出血并发症的一个因素,也是ORBIT评分系统等出血风险评估工具的一个组成部分.在心力衰竭、冠心病以及老年人群中,贫血同样被视为血栓栓塞事件的预测因子.此外,贫血还与各种心血管病患者的不良预后和/或更高的死亡率相关,例如在经皮冠状动脉介入治疗后的冠心病患者、慢性心力衰竭患者中.房颤在上述人群中同样很普遍,且作为一种慢性疾病,经常与贫血共存.然而,关于房颤患者中贫血的患病率及其与心血管病不良事件的关系,目前尚未有充分的描述.本综述主要探讨贫血对房颤患者血栓栓塞事件、出血和死亡临床不良结局的影响.
Abstract
Anemia means a decrease in hemoglobin concentration or hematocrit value,affecting a quarter of the world's population.Anemia is common in the older population and people with other chronic diseases,such as heart failure and diabetes.Atrial fibrillation(AF)is the most common arrhythmia.The risk of developing AF increases with age,with a global prevalence of approximately 0.5％,which will increase significantly in the next 50 years as the population ages.AF increases the risk of cardiac thromboembolism and death.While oral anticoagulants reduces the risk of thromboembolic events in patients with AF,it is at the cost of increased bleeding risk.Anemia has now been identified as a predictor of bleeding complications in anticoagulated patients with AF and as a component of bleeding risk assessment models such as the ORBIT score.In heart failure and coronary artery disease as well as in the elderly,anemia is likewise considered a predictor of thromboembolic events.In addition,anemia has been associated with a poorer prognosis and/or higher mortality in patients with various cardiovascular diseases,such as coronary artery disease after percutaneous coronary intervention and chronic heart failure.Atrial fibrillation is equally prevalent in these populations,and as a chronic disease,also often coexists with anemia.However,the prevalence of anemia in patients with atrial fibrillation and its association with adverse cardiovascular events have not been well described so far.This review focuses on the impact of anemia on clinical adverse outcomes of thromboembolic events,bleeding,and death in patients with atrial fibrillation.
关键词
贫血/缺铁/心房颤动/不良事件Key words
Atrial fibrillation/Anemia/Iron-deficiency/Adverse outcomes引用本文复制引用
出版年
2024
NETL
NSTL
万方数据