急性STEMI后左心室血栓形成危险因素及其院内预后分析
Risk factors and in-hospital prognosis of left ventricular thrombosis after acute STEMI
邓园园 1何安霞 1龚帆影 1俞鹏 2陈晓虎 2陶炜伟1
作者信息
- 1. 南京中医药大学附属医院(江苏省中医院)功能检查科(南京,210029)
- 2. 南京中医药大学附属医院(江苏省中医院)心血管科
- 折叠
摘要
目的:探讨急性ST段抬高型心肌梗死(STEMI)后左心室血栓(LVT)形成的危险因素及其对院内预后的影响.方法:选取2020年1月-2024年2月江苏省中医院收治的急性STEMI患者143例,根据是否合并LVT分为LVT组23例和非LVT组120例.比较两组患者基线资料、临床检验指标、超声心动图指标、冠状动脉造影情况及其住院期间主要不良心血管事件(MACE),采用多因素logistic回归分析急性STEMI患者LVT形成的独立危险因素.结果:多因素logistic回归分析显示,室壁瘤(OR=3.773,95％CI1.106-12.872,P=0.034)、Killip 分级≥ Ⅲ 级(OR=5.914,95％CI1.731～20.202,P=0.005)、LVEF＜50％(OR=3.981,95％CI1.178-13.456,P=0.026)是急性STEMI患者LVT形成的独立危险因素.与非LVT组相比,LVT组MACE发生率显著增高(5.0％vs 34.8％,P＜0.001).结论:室壁瘤、LVEF＜50％及Killip分级≥Ⅲ级是急性STEMI患者LVT形成的独立危险因素;LVT可导致STEMI患者预后不良.
Abstract
Objective:To investigate the risk factors of left ventricular thrombosis(LVT)after acute ST-seg-ment elevation myocardial infarction(STEMI)and its influence on hospital prognosis.Methods:A total of 143 a-cute STEMI patients admitted to Jiangsu Province Hospital of Traditional Chinese Medicine from January 2020 to February 2024 were selected and divided into LVT group(23 cases)and non-LVT group(120 cases).Baseline da-ta,clinical indicators,echocardiographic indicators,coronary angiography and major adverse cardiovascular events(MACE)during hospitalization were compared between the two groups.Multivariate logistic regression was used to analyze the independent risk factors for LVT formation in acute STEMI patients.Results:Multivariate logistic regression analysis showed that ventricular aneurysm(OR=3.773,95％CI1.106-12.872,P=0.034),Killip grade≥ Ⅲ(OR=5.914,95％CI1.731-20.202,P=0.005)and LVEF＜50％(OR=3.981,95％CI1.178-13.456,P=0.026)were independent risk factors for LVT formation in acute STEMI patients.Compared with the non-LVT group,the incidence of MACE was significantly higher in the LVT group(5.0％vs 34.8％,P＜0.001).Conclusion:Ventricular aneurysm,LVEF＜50％and Killip grade Ⅲ are independent risk factors for LVT formation in acute STEMI patients.LVT can lead to poor prognosis in STEMI patients.
关键词
急性ST段抬高型心肌梗死/左心室血栓/危险因素/预后Key words
acute ST-segment elevation myocardial infarction/left ventricular thrombus/risk factors/prognosis引用本文复制引用
基金项目
国家中医药管理局冠心病循证能力提升项目(2019XZZX-XXG004)
出版年
2024
NETL
NSTL
万方数据