Analysis Of Clinical Characteristics Of Pulmonary Embolism Complicated With Atrial Fibrillation

BackgroundPulmonary embolism is a common respiratory disease with a high mortality rates.Atrial fibrillation not only causes rapid increase of ventricular rates and cardiac dysfunction,but also increases the risk of venous thromboembolism in patients,which is closely related to the occurrence and development of pulmonary embolism.Studies have confirmed that atrial fibrillation is one of the causes of pulmonary embolism and pulmonary embolism can also cause atrial fibrillation,but studies on the clinical characteristics of pulmonary embolism complicated with atrial fibrillation are rare.ObjectiveIn this study,the clinical data of patients with pulmonary embolism complicated with atrial fibrillation was retrospectively analyzed to improve the understanding and diagnosis and treatment levels of clinicians on pulmonary embolism complicated with atrial fibrillation.MethodsA retrospective analysis was performed on 61 patients with pulmonary embolism complicated with atrial fibrillation(AF)admitted to the First Affiliated Hospital of Zhengzhou University from February 2012 to July 2018.A total of 122 patients(sinus rhythm group)with pulmonary embolism were selected from the First Affiliated Hospital of Zhengzhou University at the same time,which was according to the methods of the age and gender matching as the control group.All patients were followed up for 30 days after the diagnosis of pulmonary embolism(followed up by checking the medical record system or calling),and the general conditions,previous history,clinical manifestations,signs,imaging features,laboratory test results,revised Geneva score,sPESI(Simplified pulmonary embolism severity index,sPESI)score,in-hospital mortality rates and 30-day mortality rates of the two groups were analyzed.SPSS 17.0 software was used to analyze the data,Qualitative data was described by percentage(%)and chi-square test was used.Quantitative data was described by mean±standard deviation when the quantitative data was normally distributed,and Student's t test was used(Otherwise,it was described by quartile spacing and Wilcoxon rank sum test was used).Kaplan-meier was used to calculate the 30-day survival rates.The survival curves were compared by log-rank test,and P < 0.05 was considered statistically significant.Results1.Compared with sinus rhythm group,more patients with the clinical manifestations of hemoptysis and palpitation in atrial fibrillation group,more electrocardiogram ST-T changes(ST-segment deviation?0.1 mV or negative T waves)and more patients developed pleural effusion,the difference was statistically significant(P<0.05).2.Compared with sinus rhythm group,patients in atrial fibrillation group had higher NT-proBNP(N-terminal pro brain natriu-retic)levels and blood glucose levels at admission,and lower left ventricular ejection fraction,the difference was statistically significant(P<0.001).4.SPESI scores and modified Geneva scores of atrial fibrillation group were higher than that of sinus rhythm group.In addition,the 30-day all-cause mortality rates were 16.34%(10 people)in the atrial fibrillation group,which were higher than 3.3%(4 people)in the sinus rhythm group(P<0.05),and the difference in survival curves between the two groups were statistically significant(P<0.05).ConclusionsCompared with pulmonary embolism with sinus rhythm,patients with pulmonary embolism combined with atrial fibrillation were more likely to have clinical characteristics associated with poor prognosis of pulmonary embolism such as more electrocardiogram ST-T changes,higher NT-proBNP and blood glucose levels at admission,decreased left ventricular ejection fraction,higher sPESI scores and revised Geneva scores and higher 30-day mortality rates.