房颤酗酒者的戒酒研究

2020
06/28

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米勒之声
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房颤酗酒者的戒酒研究来了,赶紧来看看吧!

本文由“罂粟花”授权转载

Alcohol Abstinence in Drinkers with Atrial Fibrillation

背景与目的

过量饮酒与偶发性房颤和不良的心房重构有关;然而,戒酒对房颤二级预防的作用尚不清楚。

方  法

我们在澳大利亚的六家医院进行了一项多中心、前瞻性、开放性、随机、对照试验。收集每周饮用10杯或10杯以上标准饮品(1杯标准饮品中含约12g纯酒精)的成年人,且在窦性心律基础上伴有阵发性或持续性房颤,将他们按1:1的比例进行随机分配,一组戒酒,一组继续正常饮酒。两个主要结局是随访6个月期间无房颤复发(排除2周“戒断期”)和房颤总负荷(房颤发生的时间比例)。

结 果  

140名接受随机分组的患者中(85%为男性;平均年龄[±SD] 62±9岁),70名患者被分到戒酒组,70名被分到对照组。戒酒组患者每周饮酒量由16.8±7.7降至2.1±3.7(下降87.5%),对照组每周饮酒量由16.4±6.9降至13.2±6.5(下降19.5%)。经过2周戒断期,戒酒组70例中有37例(53%)房颤复发,对照组70例中有51例(73%)房颤复发。与对照组相比,戒酒组房颤复发前的间隔时间更长(危险比为0.55;95%CI 0.36 ~ 0.84;P = 0.005)。为期6个月的随访中,戒酒组的房颤负荷明显低于对照组(房颤发生时间的中位数百分比为0.5%[四分位数范围:0.0~3.0] vs. 1.2%[四分位数范围,0.0~10.3];P=0.01)。

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结 论

戒酒可减少房颤酗酒者的心律失常复发。

原始文献来源及摘要

Voskoboinik A, Kalman JM, De Silva A, et al. Alcohol Abstinence in Drinkers with Atrial Fibrillation.[J].N. Engl. J. Med. 2020,382(1):20-28.

Abstract

BACKGROUND

Excessive alcohol consumption is associated with incident atrial fibrillation and adverse atrial remodeling; however, the effect of abstinence from alcohol on secondary prevention of atrial fibrillation is unclear.

METHODS

We conducted a multicenter, prospective, open-label, randomized, controlled trial at six hospitals in Australia. Adults who consumed 10 or more standard drinks (with 1 standard drink containing approximately 12 g of pure alcohol) per week and who had paroxysmal or persistent atrial fibrillation in sinus rhythm at baseline were randomly assigned in a 1:1 ratio to either abstain from alcohol or continue their usual alcohol consumption. The two primary end points were freedom from recurrence of atrial fibrillation (after a 2-week “blanking period”) and total atrial fibrillation burden (proportion of time in atrial fibrillation) during 6 months of follow-up.

RESULTS

Of 140 patients who underwent randomization (85% men; mean [±SD] age, 62±9 years), 70 were assigned to the abstinence group and 70 to the control group. Patients in the abstinence group reduced their alcohol intake from 16.8±7.7 to 2.1±3.7 standard drinks per week (a reduction of 87.5%), and patients in the control group reduced their alcohol intake from 16.4±6.9 to 13.2±6.5 drinks per week (a reduction of 19.5%). After a 2-week blanking period, atrial fibrillation recurred in 37 of 70 patients (53%) in the abstinence group and in 51 of 70 patients (73%) in the control group. The abstinence group had a longer period before recurrence of atrial fibrillation than the control group (hazard ratio, 0.55; 95% confidence interval, 0.36 to 0.84; P=0.005). The atrial fibrillation burden over 6 months of follow-up was significantly lower in the abstinence group than in the control group (median percentage of time in atrial fibrillation, 0.5% [interquartile range, 0.0 to 3.0] vs. 1.2% [interquartile range, 0.0 to 10.3]; P=0.01).

CONCLUSIONS

Abstinence from alcohol reduced arrhythmia recurrences in regular drinkers with atrial fibrillation.

 (Funded by the Government of Victoria Operational Infrastructure Support Program and others; Australian New Zealand Clinical Trials Registry number, ACTRN12616000256471.)

免责声明:

文中所涉及药物使用、疾病诊疗等内容仅供参考。

END

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本文由作者自行上传,并且作者对本文图文涉及知识产权负全部责任。如有侵权请及时联系(邮箱:guikequan@hmkx.cn
关键词:
酗酒者,戒酒组,房颤

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