冠状动脉慢血流患者发生主要不良心血管事件的影响因素分析
Analysis of influencing factors of major adverse cardiovascular events in patients with coronary slow flow
王贤进 1刘晶晶 1唐娟 1陈海燕 1陈良川 1郑元喜 1项学军1
作者信息
- 1. 246000 安徽省安庆市,安庆市立医院心血管内科
- 折叠
摘要
目的 分析冠状动脉慢血流患者(CSFP)随访期间发生主要不良心血管事件(MACE)的影响因素.方法 采用回顾性观察性研究设计,纳入安庆市立医院2019年1月至2023年1月因胸痛入院行冠状动脉造影首次诊断CSFP患者249例,通过医护人员定期对入组患者门诊随访信息收集、患者或家属进行电话随访,前瞻性随访所有符合纳入标准患者MACE发生情况(包括因胸痛再住院、非致死性心肌梗死及心源性死亡),随访截止日期2023年9月.使用单因素及多因素Cox回归分析发生MACE的影响因素.结果 平均随访24.2月,共有50例(20.1%)患者发生MACE,其中46例(18.5%)因胸闷胸痛再住院,4例(1.6%)发生非致死性心肌梗死.单因素及多因素Cox回归均提示,糖尿病、平均校正TIMI血流帧数(mcTFC)和低密度脂蛋白胆固醇(LDL-C)水平与CSFP患者随访期间发生MACE相关,缺失数据多重填补后分析及完整数据分析结论一致,将mcTFC及LDL-C行分类变量转换后,Kaplan-Meier分析CSFP患者不同组组间MACE发生率有统计学差异,Log-rank P均<0.05.结论 糖尿病、mcTFC、LDL-C对CSFP患者随访期间发生MACE有一定预测价值.
Abstract
Objective To analyze the influencing factors of major adverse cardiovascular events(MACE)in patients with coronary slow flow(CSFP)during follow-up.Methods A total of 249 patients with CSFP first diagnosed by coronary angiography admitted to Anqing Municipal Hospital from January 2019 to January 2023 due to chest pain were included in the retrospective observational study design.Follow-up data were obtained through regular collection of outpatient information by medical staff or regular telephone follow-up of patients themselves or their families.All eligible patients were prospectively followed up for the occurrence of MACE(including re-hospitalization due to chest tightness and pain,nonfatal myocardial infarction,and cardiogenic death),with a follow-up deadline of September 2023.Univariate and multifactorial Cox regression were used to analyze the influencing factors of MACE.Results During a mean follow-up of 24.2 months,50 patients(20.1%)developed MACE,of which 46 patients(18.5%)were re-hospitalized due to chest tightness and pain,and 4 patients(1.6%)developed non-fatal myocardial infarction.Both univariate and multivariate Cox regression indicated that diabetes mellitus,mean corrected TIMI flow frame count(mcTFC),and low density lipoprotein cholesterol(LDL-C)were associated with MACE in CSFP patients.The results of multi-fill analysis of missing data and complete data analysis were consistent.After converting mcTFC and LDL-C into binary categorical variables,Kaplan-Meier analysis showed that there were statistical differences in the incidence of MACE among CSFP patients in different groups,with Log-rank P<0.05.Conclusion Diabetes mellitus,mcTFC and LDL-C may have predictive value for MACE occurrence in CSFP patients during follow-up.
关键词
冠状动脉慢血流/动脉粥样硬化/不良心血管事件/血脂Key words
Coronary slow flow/Atherosclerosis/Adverse cardiovascular events/Blood lipid引用本文复制引用
基金项目
安庆市立医院院级科研项目(2022aqykj01)
出版年
2024
NETL
NSTL
万方数据