A Study Of Association Between Atrial Fibrillation And Coronary Heart Disease In The Aged

【Background】Atrial fibrillation(AF) is the most common durativearrhythm. Its incidence increased as age raising. Many studies suggestedthat the incidence of AF in the aged raised significantly. AF occurred inabout 0.6% of all people, 1.9% of people younger than 65-years and 5% ofpeople older than 65-years. The incidence of AF can reach 10% in thepeople above 80-years. The main harm of AF is thromboembolism anddysfunction of haemodynamics due to AF. Especially cerebral thrombosisis usually the reason of mutilation or causing death. AF has a highmutilation, especially in the aged. So we can see there are two contradict-tory opinions about the relationship of CHD and AF. Our study willapproach the relationship between CHD and AF in the elder(＞=60-years)and whether or not CHD patients are likely to combine AF based on theanatomical and clinical documentation of the dead patients.【Objectives】To explore the relationship between CHD and AF. Andstudy the incidence of AF in the aged..And to find other independent riskfactors of AF.【Method】Selecting 540 consecutive dead cases(＞=60-years) in Beijing hospital from 1950 to 2006. Every case had its clinical documention(including ECG). All cases were divided into two groups: Atrialfibrillation group and Sinus rhythm(SR)group. Clinical and anatomicaldata were collected and imported into Epidata 3.02. Then the final datawere imported into SAS. Initial comparison between groups were madeusing a Student t test and the chi-square test for categoric variables.Independent predictors of AF were determined by using a multivariantlogistic regression analysis. A P value＜0.05 was considered statisticallysignificant.【Result】Among all 540 cases, there were 91 female. The rotio of maleto female was 4.93:1.The incidence of AF was 35.72%. The difference ofAF incidence are not statistically significant according to sex. Theaverage age of the tow groups are statistically significantly different. Theincidence of AF increases significantly as the age increasing. Theincidence of OHD in the AF group increased significantly. The incidenceof CHD in the AF group increased significantly too. The rate of misseddiagnosis was 16.73% and the misdiagnosis rate is 51.94% according toclinical standard. The incidences of RHD, geratic retrogression valvularheart disease and CHF increased significantly. There are not significantdifference between two groups in the incidences of myocarditis, diabetes,hyperlipemia, COPD and pneumocardial disease. The incidences of MVI, MVS. TVI and AVI are significantly different between the twogroups. The incidence of valvular calcification was statistically differentbetween the two groups. The differences of average heart weight and theaverage perimeter of tricuspid value orifice between the tow groups werestatistically different. The anatomic document of heart suggested that thehearts of AF patients were more weighty and their right atrium werebigger. The differences of MI incidence in two groups were statisticallysignificant. The differences of the AMI and OMI incidence are notstatistically significant between the two groups. The differences of the STsegment elevation MI and the non-ST segment elevation MI incidencewere not statistically significant between the two groups. The differencesof valvular calcification incidence were not statistically significantbetween the two groups. The differences of the count of stage number inthe sick coronary arteries were statistically significant between the twogroups. The incidence of LAD lesion in the AF group was statisticallysignificantly higher than that in the SR group. We used a multivariantlogistic regression analysis and the analysis showed that age(OR 1.335,95%CI 1.114-1.6), OHD (OR 2.019, 95%CI 1.244-3.278), CHF (OR 1.873,95% CI 1.272-2.757), MVS(OR 33.579, 95%CI 2.852-395.35)andMVI(OR, 2.163,95% CI 1.093-4.278) were the independent risk factorsof AF. 【Conclusion】Incidence of AF increases as the age raiseing. The patientsof AF is more likely to complicate the CHD. And the chanciness of CHDpatients complicate AF increases. The more severe the coronary arterylesion the more higher the incidence of AF. But CHD is not anindependent risk factor of AF. The incidence of CHD increases in the AFpatient. The AF patients are more possibly to complicate valvularcalcification, MVI, MVS, TVI, AVI. And MVI and MVS resultes inincreasing of AF incidence. Age, CHF, OHD, MVI, MVS are theindependent risk factors.