背景:尽管束支传导阻滞和房室传导阻滞被认为与心血管疾病(CVD)和死亡率有关,心脏传导阻滞(CCB)与CVD和全因死亡率之间的关系还有待探讨.
目的:探讨CCB和CVD与全因死亡率的关系。
结果:我们包括145,805名受试者(平均年龄49.7岁,81.2%的男性)来自开滦研究。CCB是通过12导联心电图(ECG)诊断的。通过多种来源确定死亡率和CVD事件,包括市政社会保险机构,医院记录,死亡证明,定期积极随访。经过12.5年的平均随访,18,301例出现全因死亡率。排除4443名基线存在CVD的受试者后,在随访期间,141,362名研究对象中发生了13,208例CVD。与非CCB组相比,CCB组的心血管疾病累积发生率和全因死亡率分别为18.38%VS12.14%和33.45%VS14.18%,分别。对于CVD,CCB组具有95%置信区间(CI)的多变量校正风险比(HR)为1.25(1.17-1.34),全因死亡率为1.31(1.25-1.38)。此外,与年龄较大的参与者相比,年轻参与者的CCB与全因死亡率和CVD的相关性普遍更强(Ps交互作用<0.001).
结论:CCB可增加一般人群的CVD风险和全因死亡率。我们的研究结果强调了预防CCB策略的重要性,以降低CVD和死亡率的风险。
BACKGROUND: Although bundle branch block and atrioventricular block are recognized to be association with cardiovascular disease (CVD) and mortality, the relationship between cardiac conduction block (CCB) and both CVD and all-cause mortality has yet to be explored.
OBJECTIVE: To explore the relationship between CCB and CVD and all-cause mortality.
RESULTS: We included 145,805 subjects (mean age 49.7 years, 81.2% males) from the kailuan study. CCB was diagnosed through a 12‑lead electrocardiograph (ECG). Mortality and CVD events were ascertained through multiple sources, including a municipal social insurance institution, hospital records, death certificates, and regular active follow-ups. After a mean follow-up of 12.5 years, 18,301 cases developed all-cause mortality. After excluding 4443 subjects with CVD presence at baseline, 13,208 cases of CVD occurred among the 141,362 study subjects during follow-up. Compared with non-CCB group, the cumulative incidence of CVD and all-cause mortality for CCB group was 18.38% VS 12.14% and 33.45% VS 14.18%, respectively. The multivariable-adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) with CCB group were 1.25(1.17-1.34) for CVD, and 1.31(1.25-1.38) for all-cause mortality. Additionally, there were generally stronger associations for CCB with all-cause mortality and CVD in younger participants compared with their older counterparts (Ps-interaction <0.001).
CONCLUSIONS: CCB can increase the risk of CVD and all-cause mortality in the general population. Our findings highlight the importance of strategies for preventing CCB to reduce the risk of CVD and mortality.