Clinical Characteristics And Risk Factors Of Atrial Fibrillation In The Elderly

Objective:1.To investigate the epidemiological characteristics of the older patients with atrial fibrillation(AF)in age,gender,the types of AF and associated causes.2.Analyze the risk factors of persistent AF(Pe AF).We can use them to pred ict and make a suitable prevention and treatment for the elderly with AF.Methods:Collect the data of elderly AF patients admitted to our hospital from September 1,2016 to September 30,2017,and summarize the epidemiological characteristics of elderly AF.The risk factors for Pe AF were analyzed by Spearman correlation analysis and multivariate logistic regression analysis.Result:From Septenber 1,2016 to September 31,2017,there were 1144 patients diagnosed with AF totally in our heart center.In accordance with the exciusion criteria,700 cases of elderly patients with AF were selected,the average age was 77.1±6.9 years old.There were 316 cases of male(45.1%)and 384 cases of female(54.9%)? 1.Age and GenderThe chosen patients was divided into three groups(65~74 years old,75~84 years old,85 years old and above).The number of AF was increased with age,and the largest proportion(49.9%)was 75~84 years old group.In every group,female was more than male(P>0.05).Divided in two groups by sex,the most patients were in the 75~84 years old group(P>0.05).2.Associated CausesThe number of different associated conditions of elderly AF : 481 cases of coronary heart disease(68.7%),406 cases of hypertension(58.0%),341 cases of heart failure(48.7%),191 cases of diabetes(27.3%),105 cases of valvular disease(15.0%),25 cases of myocardiopathy(3.6%),21 cases of sinus sick syndrome(3.0%),20 cases of pulmonary heart disease(2.9%),15 cases of lone AF(2.1%),2 cases of congenital heart disease(0.3%).Then,41 cases of rheumatic valvular disease,accounting for 39.0% of the valvular disease,5.9% of the total.3.Types of Elderly AFThere were 595 cases of patients with nonvalvular AF,accounted for 85.0% of the total.The retio of male to female was 1:1.2.In other patients with volvular AF,the retio of male to female was 1:1.3.In 314 cases of PAF,the retio of male to female was 1:1.3.In 386 cases of persistent AF,the retio of male to female was 1:1.1.Female was the most commen in all types(P>0.05).4.Clinical Data ComparisonThe age was older,the size of left atria diameter,CRP,uric acid and the incidence of heart failure,hypertension,cardiac valvular disease were higher while the LVEF was lower in Pe AF group than in PAF group(P<0.05).5.Spearman Correlation AnalysisAs a positive correlation,there were age,heart failure,valvular disease,CRP,uric acid and left atrial diameter(P<0.05),and LVEF was as negative correla tion.6.Logistic Regression AnalysisThe risk factors for Pe AF were analyzed by multivariate logistic regression analysis.Then it showed that left atria diameter and uric acid level were the independent risk factors of elderly PEAF.Conclusion:1.In the elderly,the number of AF cases increase with age.The group of 75-84 years old was the largest part.The number of older female was larger than male in all ages.It was important to pay more attention to the cases of elderly women with AF.2.In the elderly with AF,nonvalvular atrial fibrillation is normal.The top three causes of AF in the elderly were CHD,hypertension and heart failure.In the elderly,co-morbidities were frequent,and their management was a major therapeutic objective.3.CRP,left atria diameter were the independent risk factors for Pe AF in the elderly.