首页|急性冠脉综合征患者不良心血管预后的影响因素

急性冠脉综合征患者不良心血管预后的影响因素

Influencing Factors of Adverse Cardiovascular Prognosis in Patients with Acute Coronary Syndrome

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目的 探讨急性冠脉综合征(ACS)患者预后发生主要不良心血管事件(MACE)的影响因素.方法 从医院2019年2月至2022年2月收治的急性冠脉综合征患者中选取200例,随访1 a,观察MACE的发生情况,并根据随访结果进行分组,收集并对比两组一般资料[性别、年龄、体重指数(BMI)、吸烟史、饮酒史、基础合并症(高血压、糖尿病)、心血管病家族史]、临床指标(冠脉病变支数、植入支架数)、心功能指标[左室射血分数(LVEF)]、实验室指标[肌酸激酶同工酶(CK-MB)、肌钙蛋白T(cTnT)].绘制受试者工作特征(ROC)曲线分析冠脉病变支数、LVEF、CK-MB、cTnT预测ACS患者预后发生MACE的价值.采用多因素logistic回归分析明确ACS患者预后发生MACE的危险因素.结果 随访1 a后,MACE组40例(20.00%),未发生MACE组160例(80.00%).两组性别、年龄、BMI、吸烟史、饮酒史、高血压、糖尿病、心血管病家族史、植入支架数对比,差异无统计学意义(P>0.05),发生MACE组冠脉病变支数1支占比高于未发生MACE组(P<0.05),LVEF低于未发生MACE组(P<0.05),CK-MB、cTnI高于对照组(P<0.05).经ROC分析证实LVEF、CK-MB、cTnI均可预测ACS患者预后发生MACE,曲线下面积分别为0.763、0.960、0.914(P<0.05).多因素logistic回归分析显示冠脉病变支数>1支、LVEF≤53.35%、CK-MB≥173.81 U·L-1、cTnI≥0.62 μg·L-1均为ACS患者预后发生MACE的危险因素(P<0.05).结论 冠脉病变支数>1支、LVEF≤53.35%、CK-MB≥173.81 U·L-1、cTnI≥0.62 μg·L-1均为ACS患者预后发生MACE的危险因素.
Objective To investigate the influencing factors of major adverse cardiovascular events(MACE)in the prognosis of patients with acute coronary syndrome(ACS).Methods A total of 200 patients with acute coronary syndrome admitted to the hospital from February 2019 to February 2022 were followed up for 1 year to observe the occurrence of MACE,and were grouped according to the follow-up results.General data[gender,age,body mass index(BMI),smoking history,drinking history,basic complications(hypertension,diabetes),family history of cardiovascular disease],clinical indicators(number of coronary artery lesions,number of stents implanted),cardiac function indicators[left ventricular ejection fraction(LVEF)],laboratory indicators[creatine kinase isoenzyme(CK-MB),troponin T(cTnT)].Draw receiver operating characteristic(ROC)curves to analyze the value of predicting MACE in ACS patients based on the number of coronary artery lesions,LVEF,CK-MB,and cTnT.Using multiple logistic regression analysis to identify the risk factors for MACE in ACS patients.Results After 1 year of follow-up,there were 40 cases(20.00%)in the MACE group and 160 cases(80.00%)in the non MACE group.There was no significant difference in gender,age,BMI,smoking history,drinking history,hypertension,diabetes,family history of cardiovascular disease,and the number of stents implanted between the two groups(P>0.05).The number of coronary artery lesions in the group with MACE was higher than that in the group without MACE(P<0.05),LVEF was lower than that in the group without MACE(P<0.05),and CK-MB and cTnI were higher than those in the control group(P<0.05).ROC analysis confirmed that LVEF,CK-MB,and cTnI can all predict the occurrence of MACE in ACS patients,with areas under the curves of 0.763,0.960,and 0.914,respectively(P<0.05).Multivariate logistic regression analysis showed that the number of coronary artery lesions was>1,LVEF≤ 53.35%,CK-MB≥173.81 U·L-1,and cTnI ≥0.62 μg·L-1 was risk factors for the occurrence of MACE in ACS patients(P<0.05).Conclusion The number of coronary artery lesions was>1,LVEF ≤53.35%,CK-MB≥173.81 U·L-1,and cTnI≥0.62 μg·L-1 was risk factors for the occurrence of MACE in ACS patients.

acute coronary syndromeadverse cardiovascular eventsprognosisinfluence factor

杨春华、牛少辉、王珂

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周口市中心医院心内科,河南周口 466000

郑州大学第二附属医院心内科,河南郑州 450000

急性冠脉综合征 不良心血管事件 预后 影响因素

2024

河南医学研究
河南省医学科学院

河南医学研究

影响因子:0.979
ISSN:1004-437X
年,卷(期):2024.33(2)
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