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首页> 外文期刊>Journal of thrombosis and haemostasis: JTH >A longitudinal population-based study of prothrombotic factors in elderly subjects with atrial fibrillation: the Rotterdam Study 1990-1999.
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A longitudinal population-based study of prothrombotic factors in elderly subjects with atrial fibrillation: the Rotterdam Study 1990-1999.

机译:一项基于人口的纵向研究,对老年房颤患者的血栓形成因子进行了研究:《 1990-1999年鹿特丹研究》。

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摘要

BACKGROUND: A prothrombotic or hypercoagulable state in atrial fibrillation may contribute to stroke and thromboembolism. Results of longitudinal population-based studies in elderly people with atrial fibrillation are not yet available. METHODS: In the Rotterdam Study, a population-based prospective cohort study, 162 participants with atrial fibrillation at baseline, aged 55 years and over, were matched for age and gender with 324 people in sinus rhythm. Associations were examined between three coagulation factors and the risk of total and cardiac mortality and stroke. Hazard rate ratios were calculated with 95% confidence intervals using Cox's proportional hazards model, adjusted for potential confounders. RESULTS: Plasma von Willebrand factor was, age- and gender-adjusted, associated with cardiac mortality in the total population (relative risk 1.16; 1.06-1.27, per 10 IU dL(-1) increase), but statistical significance was lost after additional adjustments. A strong association (1.27; 1.08-1.50, per 5-unit increase) was found between soluble P-selectin (sP-sel) and cardiac mortality in atrial fibrillation patients but not in participants in sinus rhythm. Furthermore, the expected association between fibrinogen and cardiac mortality was observed only in those in sinus rhythm (2.60; 1.69-4.01, per unit increase), and not in atrial fibrillation. No associations were found between coagulation factors and stroke. CONCLUSIONS: In this population-based study, plasma levels of sP-sel predicted clinical adverse outcomes in atrial fibrillation, suggesting a role of platelets in the prothrombotic state associated with atrial fibrillation. Fibrinogen was a risk factor of cardiac and all-cause mortality in sinus rhythm, but not in atrial fibrillation.
机译:背景:房颤的血栓形成或高凝状态可能导致中风和血栓栓塞。尚无关于老年房颤患者的纵向人群研究结果。方法:在一项基于人群的前瞻性队列研究鹿特丹研究中,对年龄在55岁及以上的162名基线心房颤动的参与者进行了年龄和性别匹配,窦性心律为324人。检查了三种凝血因子与总风险,心脏死亡率和中风之间的关联。使用Cox的比例风险模型(针对潜在的混杂因素进行了调整),以95%的置信区间计算了风险比率。结果:血浆von Willebrand因子经年龄和性别校正后,与总人群的心脏死亡率相关(相对危险度1.16; 1.06-1.27,每增加10 IU dL(-1),但统计学显着性丢失调整。在房颤患者中可溶性P-选择素(sP-sel)与心脏死亡率之间有很强的关联性(1.27; 1.08-1.50,每增加5个单位),但在窦性心律患者中却没有。此外,仅在窦性心律(2.60; 1.69-4.01,每增加一单位)中观察到纤维蛋白原与心脏死亡率之间的预期关联,而在房颤中则未观察到。在凝血因子和中风之间未发现关联。结论:在这项基于人群的研究中,血浆sP-sel的水平预测了心房纤颤的临床不良结局,提示血小板在与心房纤颤相关的血栓形成前的作用。纤维蛋白原是窦性心律的心脏和全因死亡率的危险因素,但在房颤中却不是。

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