首页|早发急性冠脉综合征患者急诊PCI后住院期间不良预后的危险因素分析

早发急性冠脉综合征患者急诊PCI后住院期间不良预后的危险因素分析

Risk factors for poor prognosis in patients with early-onset acute coronary syndrome after emergency PCI during hospitalization

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目的:探讨早发急性冠脉综合征(ACS)患者行急诊经皮冠状动脉介入治疗(PCI)后住院期间主要不良心血管事件(MACE)的危险因素.方法:回顾性分析2019年1月至2021年12月于西南医科大学附属医院诊断为早发ACS并接受急诊PCI治疗的234例患者的临床资料,根据住院期间MACE发生情况将患者分为无MACE组(130例)和MACE组(104例),对两组患者的临床资料进行比较,采用多因素Logistic回归分析早发ACS患者行PCI后住院期间MACE的危险因素.结果:与无MACE组相比,MACE组患者年龄[49(45,53)岁比52(47,55)岁]显著更大,高血压(41.5%比66.4%)、多支血管病变比例(50.8%比67.3%)及天冬氨酸氨基转移酶(AST)[118.8(58.1,222.1)U/L 比 179.0(72.1,306.5)U/L]、肌酐[64.0(54.1,72.9)μmol/L 比 70.9(59.5,84.0)μmol/L]、D 二聚体(D-D)[0.3(0.2,0.5)mg/L 比 0.7(0.3,1.7)mg/L]、N 末端脑钠肽前体(NT-proBNP)峰值水平[188.0(100.0,570.8)pg/ml 比 2044.5(688.0,3527.8)pg/ml]显著升高,血红蛋白(Hb)[148(139,156)g/L 比 139(126,155)g/L]水平显著下降(P<0.05 或<0.01).多因素 Logistic 回归分析显示,高血压(OR=3.711,95%CI 1.450~9.500,P=0.006)、D-D(OR=2.385,95%CI 1.353~4.206,P=0.003)、NT-proBNP 峰值水平(OR=1.002,95%CI 1.001~1.003,P<0.001)是早发 ACS 患者急诊PCI后住院期间MACE的独立危险因素.结论:高血压、D-D、NT-proBNP峰值水平可独立预测早发ACS患者急诊PCI后短期不良预后情况,应尽早干预,改善患者预后.
Objective:To investigate the risk factors of major adverse cardiovascular events(MACE)in patients with early-onset acute coronary syndrome(ACS)after emergency percutaneous coronary intervention(PCI)during hospitalization.Methods:Clinical data of 234 patients who were diagnosed with early-onset ACS and received emergency PCI in the Affil-iated Hospital of Southwest Medical University between January 2019 and December 2021 were retrospectively analyzed.According to the occurrence of MACE during hospitalization,the patients were divided into no MACE group(n=130)and MACE group(n=104),and the clinical data were compared between two groups.Multivariate Logistic regression was used to analyze the risk factors of MACE in patients with early-onset ACS after PCI during hospitalization.Results:Compared with those in no MACE group,patients in MACE group had significant higher age[49(45,53)years vs.52(47,55)years],proportions of hypertension(41.5%vs.66.4%)and multi-vessel coronary disease(50.8%vs.67.3%),levels of aspartate aminotransferase(AST)[118.8(58.1,222.1)U/L vs.179.0(72.1,306.5)U/L],creatinine[64.0(54.1,72.9)μmol/Lvs.70.9(59.5,84.0)μmol/L],D-dimer(D-D)[0.3(0.2,0.5)mg/L vs.0.7(0.3,1.7)mg/L]and peak N terminal pro brain natriuretic peptide(NT-proBNP)[188.0(100.0,570.8)pg/ml vs.2044.5(688.0,3527.8)pg/ml],and significant lower hemoglobin(Hb)level[148(139,156)g/L vs.139(126,155)g/L(P<0.05 or<0.01).Multivariate Logistic regression analysis indicated that hypertension(OR=3.711,95%CI 1.450~9.500,P=0.006),D-D(OR=2.385,95%CI 1.353~4.206,P=0.003)and NT-proBNP peak level(OR=1.002,95%CI 1.001~1.003,P<0.001)were independent risk factors for MACE in early-onset ACS patients after emergency PCI during hospitalization.Conclusion:Hypertension,D-D and NT-proBNP peak level could independently predict the short-term poor prognosis of patients with early-onset ACS after emergency PCI.Early intervention should be carried out to improve the prognosis of patients.

Acute Coronary SyndromeRisk factorsPrognosis

李锦、王鼎、朱秋霞、范忠才、杨萍

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西南医科大学附属医院心血管内科,四川泸州 646000

急性冠脉综合征 危险因素 预后

2024

心血管康复医学杂志
福建省康复医学会 中国康复医学会

心血管康复医学杂志

CSTPCD
影响因子:1.157
ISSN:1008-0074
年,卷(期):2024.33(6)