RESULTS: We included participants from the FHS (Framingham Heart Study) from 1960 and onwards. We assessed the hazard ratio (HR) of new-onset AF and MI, and mortality according to MI and AF status (prevalent and interim) using multivariable-adjusted Cox proportional hazards models. Interim diseases were modeled as time-varying variables. For the analysis of new-onset AF, 10 923 participants (55% women; mean±SD age, 54±8 years) were included. For new-onset MI, 10 804 participants (55% women; mean±SD age, 54±8 years) were included. Compared with no MI, the hazard of new-onset AF was higher in participants with prevalent (HR, 1.60 [95% CI, 1.32-1.94]) and interim MI (HR, 3.96 [95% CI, 3.18-4.91]). Both ST-segment-elevation MI and non-ST-segment-elevation MI were associated with new-onset AF. Interim AF, not prevalent AF, was associated with higher hazard rate of new-onset MI (HR, 2.21 [95% CI, 1.67-2.92]). Interim AF was associated with both ST-segment-elevation MI and non-ST-segment-elevation MI. Mortality was significantly greater among participants with AF and MI compared with participants with 1 of the 2, regardless of temporal order.
CONCLUSIONS: We report a bidirectional association between AF and MI, which was observed for both non-ST-segment-elevation MI and ST-segment-elevation MI. Participants with both AF and MI had considerably higher mortality compared with participants with only 1 of the 2 conditions, regardless of order.
结果:我们纳入了1960年及以后的FHS(弗雷明汉心脏研究)的参与者。我们评估了新发房颤和心肌梗死的风险比(HR),使用多变量校正Cox比例风险模型,根据MI和AF状态(流行和中期)和死亡率。中期疾病被建模为时变变量。对于新发房颤的分析,10923名参与者(55%女性;平均±SD年龄,包括54±8年)。对于新发MI,10804名参与者(55%女性;平均±SD年龄,包括54±8年)。与没有MI相比,新发房颤的危险在普遍存在的参与者中更高(HR,1.60[95%CI,1.32-1.94])和中期MI(HR,3.96[95%CI,3.18-4.91])。ST段抬高型MI和非ST段抬高型MI均与新发房颤相关。临时AF,不是普遍的AF,与较高的新发MI危险率相关(HR,2.21[95%CI,1.67-2.92])。中期房颤与ST段抬高MI和非ST段抬高MI均相关。无论时间顺序如何,房颤和MI参与者的死亡率均明显高于2名参与者中的1名。
结论:我们报告了房颤和MI之间的双向关联,观察到非ST段抬高MI和ST段抬高MI。与仅有两种情况中的一种的参与者相比,患有AF和MI的参与者的死亡率要高得多。不管顺序。