İleri Yaş Atriyal Fibrilasyonlu Hastalarda Yaşa Bağlı Değişiklikler

Öz

Amaç: Atriyal fibrilasyon (AF), dünya çapında en sık karşılaşılan kardiyak aritmidir. Yaşla birlikte görülme sıklığı önemli ölçüde artmaktadır. Buna rağmen, yaşlı hastalar klinik çalışmalarda yeterince temsil edilmemekte ve bu gruba optimal medikal tedavi daha seyrek verilmektedir. Bu çalışmanın amacı, AF’si olan yaşlı hastalarda yaşa bağlı değişiklikleri değişiklikleri saptamaktır. Gereç ve Yöntem: 75 yaş ve üzeri (orta yaşlılar) kalıcı atriyal fibrilasyonu olan 118 hasta ile 65-75 yaş arası (genç yaşlılar) kalıcı atriyal fibrilasyonu olan 153 hasta retrospektif olarak değerlendirildi. Gruplar arasındaki demografik, biyokimyasal ve ekokardiyografik parametreler karşılaştırıldı. Bulgular: 75 yaş ve üzeri atriyal fibrilasyonlu hastalarda 85 (%72) hipertansiyon, 43 (%36) diyabet mellitus ve 56 (%48) koroner arter hastası vardı. 65-75 yaş arası atriyal fibrilasyonlu hastalarda ise 91 (%60) hipertansiyon, 43 (%28) diyabet mellitus ve 60 (%39) koroner arter hastası vardı. 75 yaş ve üzeri hastalarda, 65-75 yaş arası hastalara kıyasla daha fazla sayıda hipertansiyon, diyabet mellitus ve koroner arter hastalığı vardı (sırasıyla p=0.021, p=0.092, p=0.108). Ancak istatistiksel olarak anlamlılık düzeyine yalnızca hipertansiyon ulaştı. Ayrıca 75 yaş ve üzeri hastalarda kreatinin [1,15±0,36 mg/dl'ye karşı 1,03±0,23 mg/dl, p=0,003] ve üre [53,4±29,8 mg/dl'ye karşı 41,4±15,5 mg/dl, p<0,001] düzeyleri daha yüksek iken; eGFR [54,9±14,8 ml/dk vs 69,5±17,7 ml/dk, p<0,001], hemoglobin (11,5±2,1 g/dl vs 12,9±1,8 g/dl, p<0,001) ve albümin [3,67±0,54 g/dl vs 4±0,44 g/dl, p=0,003] düzeyleri daha düşük saptandı. Sonuç: AF'li hastalarda yaş ilerledikçe, başta hipertansiyon ve kronik böbrek hastalığı olmak üzere eşlik eden hastalıklar artmaktadır. Bu hastalarda AF tedavisini optimize etmek yanında, aynı zamanda eşlik eden hastalıkları da yönetmek önemlidir.

Anahtar Kelimeler

• Atriyal fibrilasyon
• Yaşlanma
• Geriatri

Destekleyen Kurum

Yok

Etik Beyan

Bu retrospektif çalışma, Helsinki Bildirgesi'ne uygun olarak Balıkesir Üniversitesi Klinik Araştırma Etik Kurulu tarafından onaylanmıştır (Karar no: 2023/137; Tarih: 11.10.2023).

Teşekkür

Yok

Age-Related Differences in Elderly Patients with Atrial Fibrillation

Öz

Objective: Atrial fibrillation (AF) is the most common cardiac arrhythmia worldwide. Its prevalence increases significantly with age. Therefore, it is particularly important in the elderly population. Despite this, elderly patients have been underrepresented in clinical studies, and optimal medical treatment is less frequently provided to this group. The aim of this study is to identify age-related patterns in elderly patients and to evaluate their relationships with comorbidities. Materials and Methods: 118 patients with permanent AF aged ≥75 years (middle-old) and 153 patients with permanent AF aged 65-75 years (youngest-old) were retrospectively evaluated. Demographic, biochemical and echocardiographic parameters were compared between groups. Results: There were 85 cases (72%) of hypertension, 43 cases (36%) of diabetes mellitus, 56 cases (48%) of coronary artery disease in patients with AF aged ≥75 years. There were 91 cases (60%) of hypertension, 43 cases (28%) of diabetes mellitus, 60 cases (39%) of coronary artery disease in patients with AF aged 65-75 years. Patients with AF aged ≥75 years had more hypertension, diabetes mellitus and coronary artery disease compared to the patients with AF aged 65-75 years (p=0.021, p=0.092, p=0.108, respectively). However, only hypertension reached statistical significance. Also, creatinine [1.15±0.36 mg/dl vs 1.03±0.23 mg/dl, p=0.003], urea [53.4±29.8 mg/dl vs 41.4±15.5 mg/dl, p<0.001] levels were higher; while eGFR [54.9±14.8 ml/min vs 69.5±17.7 ml/min, p<0.001], hemoglobin (11.5±2.1 g/dl vs 12.9±1.8 g/dl, p<0.001) and albumin [3.67±0.54 g/dl vs 4±0.44 g/dl, p=0.003] levels were lower in patients with AF aged ≥75 years compared to the patients with AF aged 65-75 years. Conclusion: Comorbidities especially hypertension and chronic kidney disease are more frequently observed in patients with AF as age increases. It is important to remember that in elderly patients with AF, it is essential to manage not only the arrhythmia itself but also any additional comorbidities.

Anahtar Kelimeler

• Atrial fibrillation
• Elderly
• Geriatric

Destekleyen Kurum

None

Etik Beyan

This retrospective study was approved by the Balikesir University Clinical Research Ethics Committee according to the Declaration of Helsinki (Decision no: 2023/137; Date: 11.10.2023).

Teşekkür

None

Kaynakça

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