Analysis Of Risk Factors For The Development Of Heart Failure And Atrial Fibrillation In Patients With Hypertensive Heart Disease And Coronary Artery Disease

BackgroundHypertensive heart disease and coronary heart disease are common cardiovascular diseases,while atrial fibrillation is a common clinical arrhythmia with serious public health implications.In recent years,there has been an increasing number of studies on the relationship between AF and metabolism,and the related findings are inconsistent,so it is important to further de-exploit the related risk factors and assess their predictive efficacy for AF.ObjectivesTo investigate the risk factors for the development of AF in patients with hypertensive heart disease and coronary artery disease.To identify and manage high-risk patients at an early stage in the community so as to improve the prognosis of patients.MethodsIn this study,281 patients with complete case data and clear diagnosis of hypertensive heart disease and stable coronary heart disease who were hospitalized and treated at the Second Affiliated Hospital of Guangzhou Medical University from May 2019 to April 2021 on the research data platform of the Second Affiliated Hospital of Guangzhou Medical University were included as study subjects using a retrospective analysis.Included data included: general data(e.g.,age,sex,hypertension,coronary artery disease,diabetes,systolic blood pressure,diastolic blood pressure,heart rate,etc.);comprehensive biochemical indices(e.g.,brain natriuretic peptide,triglycerides,HDL cholesterol,LDL cholesterol,ApoA1,Apo B,total protein,albumin,globulin,complement C3,complement C4,estimated glomerular filtration rate,creatinine,uric acid,urea,etc.);echocardiographic indices(e.g.,right ventricular outflow tract(RVOT),aortic internal diameter(AO),left atrial internal diameter(LAD),left ventricular end-diastolic internal diameter(LVDd),left ventricular posterior wall thickness(LVPW),pulmonary artery internal diameter(PA),septal thickness(IVS),ejection fraction(EF),peak mitral valve early diastolic flow velocity E(E-peak),etc.).Patients were divided into non-atrial fibrillation and atrial fibrillation groups according to the presence or absence of atrial fibrillation.Baseline data were compared by independent samples t-test or nonparametric test,and risk factors for the development of AF in patients were determined by single-and multifactor logistic regression analysis.ROC curve analysis was used to assess the predictive ability of single and multiple risk factor combinations for the development of AF in patients with hypertensive heart disease and coronary artery disease.ResultsThe 281 patients were divided into atrial fibrillation and non-atrial fibrillation groups.Comparison of baseline data revealed statistically significant differences between the two groups in heart rate,left atrial internal diameter,peak mitral valve early diastolic flow velocity E,triglycerides,HDL,LDL,ApoA1,Apo B,albumin,albumin/globulin,complement C3,and complement C4,and one-way logistic regression analysis showed that The two groups were associated with the occurrence of AF in terms of heart rate,left atrial internal diameter,E peak,triglycerides,HDL-C,LDL-C,ApoA1,Apo B,albumin,albumin/globulin,and complement C3.Multifactorial logistic regression of the above variables showed that LAD,E-peak,and heart rate were positively correlated with the occurrence of AF.With increasing levels of LAD(OR 3.635,95% CI: 2.051-6.643,P < 0.001),E-peak(OR 5.591,95%CI: 1.578-19.808,P = 0.008),and heart rate(OR 1.028,95% CI: 1.005-1.051,P =0.017),hypertensive ApoA1 was negatively associated with the development of AF,and the risk of AF in patients with hypertensive heart disease and coronary artery disease decreased with increasing levels of ApoA1(OR 0.007,95% CI: 0.000-0.118,P=0.001).In the ROC curve analysis,the area under the ROC curve for the combined prediction of AF by LAD and ApoA1 was 0.822(95% CI: 0.772-0.872,P < 0.001),with a sensitivity and specificity of 77.7% and 71.8%,respectively,showing some predictive value.conclusions:1.left atrial diameter(LAD),E-peak,and heart rate were positively correlated with the occurrence of atrial fibrillation in patients with hypertensive heart disease and coronary artery disease,and apolipoprotein A1(ApoA1)was significantly and negatively correlated with the occurrence of atrial fibrillation in patients with hypertensive heart disease and coronary artery disease.2.The combination of LAD and ApoA1 improved the predictive efficacy of the occurrence of AF in patients with hypertensive heart disease and coronary artery disease compared with that of LAD or ApoA1 alone.