摘要
目的分析发生罪犯血管急性闭塞非ST段抬高型心肌梗死(NSTEMI)患者的临床特征和罪犯血管急性闭塞对院内结局影响。方法回顾性入选2016年1月至2019年8月于河北省人民医院心内科诊断为NSTEMI的266例患者,将罪犯血管血流TIMI分级0~1级和无侧枝循环定义为急性闭塞。根据有无罪犯血管急性闭塞将患者分为两组,并比较两组临床基线特征、冠脉造影特征及院内事件发生率,通过Logistic回归分析急性闭塞对NSTEMI患者院内事件影响。结果266例患者中32例(12.0%)发生罪犯血管急性闭塞,罪犯血管左回旋支更多(43.8%vs.25.6%,P<0.05),院内事件发生率较高(12.5%vs.3.4%,P<0.05),主要表现为发生恶性心律失常。经多因素Logistic回归分析,Killip分级(OR=3.531,95%CI:1.301~9.578,P<0.05)、罪犯血管急性闭塞(OR=4.401,95%CI:1.100~17.599,P<0.05)是NSTEMI患者院内事件的独立危险因素。结论罪犯血管急性闭塞的NSTEMI患者罪犯血管为回旋支比例更高,院内事件和恶性心律失常发生率更高。罪犯血管急性闭塞、Killip分级是预测NSTEMI患者院内事件的独立危险因素。
Objective To analyze the clinical characteristics in patients with non-ST-segment elevation myocardial infarction(NSTEMI)and acute culprit vessel occlusion and influence of acute culprit vessel occlusion on in-hospital outcomes.Methods NSTEMI patients(n=266)were retrospectively chosen from Department of Cardiology in People’s Hospital of Hebei Province from Jan.2016 to Aug.2019.It was defined as acute culprit vessel occlusion when TIMI flow grades of culprit vessels were grades 0-1 and there was no collateral circulation.The patients were divided,according to whether or not they had acute culprit vessel occlusion,into occlusion group and non-occlusion group.The clinical baseline characteristics,coronary angiography characteristics and incidence rates of in-hospital cardiovascular events were compared between 2 groups.The influence of acute culprit vessel occlusion on in-hospital cardiovascular events was analyzed by using Logistic regression analysis.Results In 266 patients,acute culprit vessel occlusion was occurred in 32 patients(12.0%).The left circumflex artery being culprit artery were more(43.8%vs.25.6%,P<0.05)and incidence rates of in-hospital cardiovascular events(mainly malignant arrhythmia)were higher(12.5%vs.3.4%)in occlusion group than those in non-occlusion group(P<0.05).The results of multi-factor Logistic regression analysis showed that Killip grades(OR=3.531,95%CI:1.301~9.578,P<0.05)and acute culprit vessel occlusion(OR=4.401,95%CI:1.100~17.599,P<0.05)were independent risk factors of in-hospital cardiovascular events in NSTEMI patients.Conclusion The proportion of left circumflex artery being culprit artery is higher,and incidence rates of in-hospital cardiovascular events and malignant arrhythmia are higher in patients with NSTEMI and acute culprit vessel occlusion.The acute culprit vessel occlusion and Killip grades are independent risk factors of predicting in-hospital cardiovascular events in NSTEMI patients.
作者
孟阳
李树仁
吕晓
郝潇
Meng Yang;Li Shuren;Lyu Xiao;Hao Xiao(First Department of Cardiology,People's Hospital of Hebei Province,Shijiazhuang 050000,China.;不详)
出处
《中国循证心血管医学杂志》
2023年第2期226-229,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
非ST段抬高型心肌梗死
罪犯血管
急性闭塞
Non-ST-segment elevation myocardial infarction
Culprit vessel
Acute occlusion
