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Prevalence of modifiable risk factors and relation to stroke and death in patients with atrial fibrillation: A report from the China atrial fibrillation registry study

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机构: [1]Capital Med Univ, Natl Clin Res Ctr Cardiovasc Dis, Beijing AnZhen Hosp, Dept Cardiol, Beijing, Peoples R China; [2]Capital Med Univ, Beijing Friendship Hosp, Dept Cardiol, Beijing, Peoples R China; [3]Heart Hlth Res Ctr, Beijing, Peoples R China; [4]Hebei Gen Hosp, Dept Cardiol, Shijiazhuang, Hebei, Peoples R China; [5]Univ Penn, Dept Biostat & Epidemiol, Perelman Sch Med, Philadelphia, PA 19104 USA; [6]East China Normal Univ, Dept Stat & Actuarial Sci, Shanghai, Peoples R China; [7]Univ Liverpool, Liverpool Heart & Chest Hosp, Liverpool Ctr Cardiovasc Sci, Liverpool, Merseyside, England; [8]Capital Med Univ, Beijing AnZhen Hosp, Dept Cardiol, 2 Anzhen Rd, Beijing 100029, Peoples R China
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关键词: all-cause mortality atrial fibrillation modifiable risk factors nonfatal ischemic stroke

摘要:
Background Lifestyle and risk factor management may improve outcomes in patients with atrial fibrillation (AF). We aim to evaluate the prevalence of modifiable risk factors and how these factors impact clinical outcomes in patients with AF. Methods and Results Data on 17 898 AF cohort patients with AF enrolled between 2011 and 2016 was analyzed. A healthy lifestyle was defined as not smoking, not drinking, a healthy body mass index (BMI), untreated total cholesterol less than 200 mg/dL, untreated blood pressure (BP) less than 120/80 mm Hg, and untreated fasting plasma glucose (FPG) less than 100 mg/dL. The association between risk factors and risk of the composite endpoint of all-cause mortality and nonfatal ischemic stroke were assessed using Cox proportional hazards regression model. Only 4.0% of patients achieved a healthy lifestyle. In multivariate analysis, current smoking, a low BMI, not well-controlled FPG were independently and significantly associated with higher risk of all-cause mortality and nonfatal ischemic stroke, with corresponding hazard ratio (HR) estimates 1.22 (95% confidence interval [CI], 1.00-1.47), HR = 1.72 (95% CI, 1.34-2.20), and HR = 1.25 (95% CI, 1.06-1.46), respectively. High BP was also associated with higher risk with the outcomes (HR = 1.15, 95% CI, 1.00-1.34). Compared with patients with no risk factor, those who failed to maintained or achieved optimal risk factor control had a progressively higher risk of death and nonfatal ischemic stroke (HR for 1 risk factor = 1.44; 95% CI, 1.07-1.92; and more than 2 risk factors = 1.75; 95% CI, 0.99-3.09). Conclusions Maintenance of well-controlled risk factors may substantially lower the risk of death and ischemic stroke in patients with AF.

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出版当年[2018]版:
大类 | 3 区 医学
小类 | 3 区 心脏和心血管系统
最新[2023]版:
大类 | 3 区 医学
小类 | 3 区 心脏和心血管系统
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出版当年[2017]版:
Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
最新[2023]版:
Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

影响因子: 最新[2023版] 最新五年平均 出版当年[2017版] 出版当年五年平均 出版前一年[2016版] 出版后一年[2018版]

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第一作者机构: [1]Capital Med Univ, Natl Clin Res Ctr Cardiovasc Dis, Beijing AnZhen Hosp, Dept Cardiol, Beijing, Peoples R China;
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通讯机构: [1]Capital Med Univ, Natl Clin Res Ctr Cardiovasc Dis, Beijing AnZhen Hosp, Dept Cardiol, Beijing, Peoples R China; [8]Capital Med Univ, Beijing AnZhen Hosp, Dept Cardiol, 2 Anzhen Rd, Beijing 100029, Peoples R China
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