Co-Author(s):
Leonid Dvoretski, MD - professor, First Moscow State Medical Universilty
(Sechenov University)
Tatyana Eliseeva, No - physician, War Veterans Hospital N3
Olga Vakulenko, No - Head, War Veterans Hospital N3
First Moscow State Medical Universilty (Sechenov University)
8-2, Trubetskaya str., Moscow
Introduction | Objectives: There are few data available on metabolic disorders in very elderly
patients with atrial fibrillation, therefore we investigate these
disorders.
Methods: Cross sectional data from 475 hospitalized patients with coronary
artery disease were analyzed. The patients’ age ranged from 75 to 106
years; the mean age was 88.3+ 5.1 years. The majority of study
participants (74.1%) were women.
Results: Prevalence of atrial fibrillation in this study was 34.3%. Atrial
fibrillation was diagnosed more often in patients with hyperuricemia -
in 43% versus 29.4% of patients with normal uric acid (p=0.001).
Hyperuricemia was significantly associated with risk of atrial
fibrillation (hazard ratio=1.8 (95% CI=1.2-2.7); p=0.001). Left atrium
dilatation was registered in 82.6% of patients with hyperuricemia
whereas in patients with normal uric acid level – in 77.1% of cases
(p=0.004). Concentrations of all blood lipids in patients with atrial
fibrillation were significantly lower than in patients without this
arrhythmia. The largest differences were in total cholesterol (4.4 vs
5.1 mmol/l in patients without atrial fibrillation; p<
0.0001), in triglycerides (1.2 and 1.6 mmol/L; p=0.00002) and in LDL
cholesterol level (2.4 and 3.0 mmol/L; p=0.0007). Highly significant
inverse correlations were established between left atrium diameter and
total cholesterol (r=-0.25;p< 0.0001), LDL cholesterol
(r=-0,22;p=0.01) and HDL cholesterol (r=-0.25;p=0.003) levels. 50% of
obese patients were diagnosed with atrial fibrillation, while in the
non-obese group this arrhythmia was registered in 31.3% (p=0.001).
Obese patients had larger left atrium diameter compared to patients with
normal body mass index (45.2 vs 43.5 mm, respectively;p=0.007). In
patients with atrial fibrillation and without this arrhythmia, the mean
fasting blood glucose concentrations did not differ - 6.0+ 2.1 and
6.2+ 2.4 mmol/L, respectively (p=0.64). Atrial fibrillation was
registered in 34.8% of patients with diabetes mellitus and 34.5% of
patients without diabetes (p=0.95).
Conclusions: The study results indicate some features of different metabolic
disorders in very elderly patients and centenarians with atrial
fibrillation.