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ESC 2017：AFFIRM：关注SBP-VVV，可影响房颤患者的预后

2017-08-31 MedSci MedSci原创

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患者每次就诊时收缩压（SBP）的变化与不良的临床结局密切相关。AFFIRM研究结果表明，控制血压的稳定性十分重要，对于所有类型房颤患者来说均是如此，而无论其年龄、高血压史、血压水平或凝血风险如何。 AFFIRM是一个前瞻性随机对照研究，对比了AF患者的两种治疗策略。研究共纳入了3843名患者，记录这些患者2、4、8、12个月时的SBP-VVV水平（SBP随访结果与基线标准的偏差），并在招募后

患者每次就诊时收缩压（SBP）的变化与不良的临床结局密切相关。AFFIRM研究结果表明，控制血压的稳定性十分重要，对于所有类型房颤患者来说均是如此，而无论其年龄、高血压史、血压水平或凝血风险如何。

AFFIRM是一个前瞻性随机对照研究，对比了AF患者的两种治疗策略。研究共纳入了3843名患者，记录这些患者2、4、8、12个月时的SBP-VVV水平（SBP随访结果与基线标准的偏差），并在招募后每4个月记录一次。

根据SBP-VVV的水平将患者进行四等分：＜10.09 mm Hg（1st）；10.09-13.85 mm Hg（(2nd）；3rd 13.86-17.33 mm Hg（3rd）；≥17.34 mm Hg（4th）。

平均随访3.6年，共有149例卒中以及248例大出血事件，且随着SBP的水平升高风险水平也上升。具体来说，卒中发生率从第一至第四等分逐步递升，分别为2.5％、3.0％、3.8％和6.2％（P＜0.001）。相似地，大出血发生率分别为10.8%、11.2%、15.6%,和20.8％（P＜0.001）。

校正变量后，第三和第四分位卒中（分别为[HR]: 1.85 和2.33, p=0.042 和 p=0.004）和大出血（分别为HR: 1.92和2.88, p=0.009和p<0.001）发生率仍明显上升。

总之，该研究结果表明，随访过程中，更好的控制血压变化可改善AF患者的治疗及临床结局。

原始出处：

Atrial fibrillation and blood pressure: more than just a number (AFFIRM). 28 Aug 2017.

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    2017-09-14 虈亣靌

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    2017-09-10 虈亣靌

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    2017-09-02 zhouqu_8

    #房颤患者#

    0

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    2017-08-31 虈亣靌

    未来的发展前景广阔

    0

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    2017-08-31 flysky120

    谢谢.学习一下知识

    0

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    2017-08-31 忠诚向上

    好好看下.内容丰富

    0

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    2017-08-31 飛歌

    学习了很有用不错

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=244083, encodeId=9f622440831c, content=学习了学习了学习了学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Thu Sep 14 23:50:57 CST 2017, time=2017-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=242672, encodeId=6e022426e281, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Sun Sep 10 23:26:32 CST 2017, time=2017-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1614389, encodeId=130a16143898e, content=<a href='/topic/show?id=64f95426122' target=_blank style='color:#2F92EE;'>#房颤患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54261, encryptionId=64f95426122, topicName=房颤患者)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Sep 02 02:38:00 CST 2017, time=2017-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239068, encodeId=248823906876, content=未来的发展前景广阔, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Thu Aug 31 18:35:21 CST 2017, time=2017-08-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=238987, encodeId=7d1023898eed, content=谢谢.学习一下知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Thu Aug 31 12:26:55 CST 2017, time=2017-08-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=238981, encodeId=5176238981e9, content=好好看下.内容丰富, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Aug 31 12:18:17 CST 2017, time=2017-08-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=238975, encodeId=34cd2389e52a, content=学习了很有用不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Thu Aug 31 12:12:12 CST 2017, time=2017-08-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=238971, encodeId=b4d22389e13a, content=学习受益匪浅.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=10, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Thu Aug 31 12:11:36 CST 2017, time=2017-08-31, status=1, ipAttribution=)]
    2017-08-31 清风拂面

    学习受益匪浅.谢谢分享

    0