Latest incidence and electrocardiographic predictors of atrial fibrillation: a prospective study from China / 中华医学杂志(英文版)

BACKGROUND@#China bears the biggest atrial fibrillation (AF) burden in the world. However, little is known about the incidence and predictors of AF. This study aimed to investigate the current incidence of AF and its electrocardiographic (ECG) predictors in general community individuals aged over 60 years in China.@*METHODS@#This was a prospective cohort study, recruiting subjects who were aged over 60 years and underwent annual health checkups from April to July 2015 in four community health centers in Songjiang District, Shanghai, China. The subjects were then followed up from 2015 to 2019 annually. Data on sociodemographic characteristics, medical history, and the resting 12-lead ECG were collected. Kaplan-Meier curve was used for showing the trends in AF incidence and calculating the predictors of AF. Associations of ECG abnormalities and AF incidence were examined using Cox proportional hazard models.@*RESULTS@#This study recruited 18,738 subjects, and 351 (1.87%) developed AF. The overall incidence rate of AF was 5.2/1000 person-years during an observation period of 67,704 person-years. Multivariable Cox regression analysis indicated age (hazard ratio [HR], 1.07; 95% confidence interval [CI]: 1.06-1.09; P < 0.001), male (HR, 1.30; 95% CI: 1.05-1.62; P = 0.018), a history of hypertension (HR, 1.55; 95% CI: 1.23-1.95; P < 0.001), a history of cardiac diseases (HR, 3.23; 95% CI: 2.34-4.45; P < 0.001), atrial premature complex (APC) (HR, 2.82; 95% CI: 2.17-3.68; P < 0.001), atrial flutter (HR, 18.68; 95% CI: 7.37-47.31; P < 0.001), junctional premature complex (JPC) (HR, 3.57; 95% CI: 1.59-8.02; P = 0.002), junctional rhythm (HR, 18.24; 95% CI: 5.83-57.07; P < 0.001), ventricular premature complex (VPC) (HR, 1.76; 95% CI: 1.13-2.75, P = 0.012), short PR interval (HR, 5.49; 95% CI: 1.36-22.19; P = 0.017), right atrial enlargement (HR, 6.22; 95% CI: 1.54-25.14; P = 0.010), and pacing rhythm (HR, 3.99; 95% CI: 1.57-10.14; P = 0.004) were independently associated with the incidence of AF.@*CONCLUSIONS@#The present incidence of AF was 5.2/1000 person-years in the studied population aged over 60 years in China. Among various ECG abnormalities, only APC, atrial flutter, JPC, junctional rhythm, short PR interval, VPC, right atrial enlargement, and pacing rhythm were independently associated with AF incidence.

Variation of lipid profile in patients with acute myocardial infarction of different age groups / 中华全科医师杂志

Objective To investigate the variation of lipid profile in patients with acute myocardial infarction (AMI) of different age groups.Methods Total 1214 patients of AMI were admitted to our hospital from May 2007 to July 2011.The age of patients ranged 40-89 years,and patients were divided into 5 age groups with 10-years step.Differences in lipid levels were observed by using pair-wise comparison among different age groups.Results Pair-wise comparisons among different age groups indicated that TC levels were higher in 40-69 years age groups [(4.71 ± 1.08),(4.80 ± 1.30),(4.69 ± 1.03) mmol/L,respectively] than those in the 70-89 age groups [(4.41 ± 0.96),(4.38 ± 1.03) mmol/L],all P ＜ 0.05(t values were 2.381,2.323,4.382,3.965,3.317,3.096).TG levels among three age groups ＜ 59 years had no significant difference,which were higher than those in groups over 60 years.Among 50-89 years age groups,TG gradually reduced with increase of age.HDL levels were lower in 40-59 years age groups [(1.03 ± 0.23),(1.05 ± 0.26) mmol/L,respectively] than those in 60-89 years age groups [(1.11 ±0.28),(1.11±0.28),(1.16±0.34) mmol/L,respectively],allP＜0.05 (t values were-2.777,-2.789,-3.731,-2.543,-2.566,-3.644).Total cholesterol (TC) (r =-0.123,P ＜0.01),lowdensity lipoprotein cholesterol (LDL) (r =-0.139,P ＜ 0.01) and triglyceride (TG) (r =-0.287,P ＜0.01) were negatively but high-density lipoprotein cholesterol (HDL) (r =0.125,P ＜ 0.01) was positively correlated with age of patients.TC levels in female patients were higher than those in male patients in 50-89 years age groups; LDL levels in female patients were higher than those in male patients in 50-69 years age groups and HDL levels in female patients were higher than those in male patients in 40-79 years age groups (all P ＜ 0.05,t values were-2.878,-3.007,-3.352,-3.333).Conclusions Results show that the non-elderly AMI patients (＜60 years) have higher levels of TC,LDL and TG,and lower level of HDL than the elderly patients; the TC,LDL and HDL levels are higher in female AMI patients than those in male patients at the same age groups.