摘要
目的分析急性心肌梗死(AMI)合并房颤(AF)患者的临床特征、冠状动脉血管病变分布特点及短期预后。方法回顾性收集AMI的患者的临床资料并进行电话或门诊随访。依据心电图结果将患者分为合并AF组以及窦性心律组,对比两组患者间临床特征、冠状动脉血管病变分布特点以及短期心血管不良事件发生情况和预后。结果共纳入226例患者,其中AMI合并AF(A组)患者84例,窦性心律AMI(B组)患者142例。A组患者年龄、既往心梗史发生率、KILLIP分级Ⅲ级患者占比、左心房内径均高于B组,左室射血分数、KILLIP分级Ⅰ级患者占比均低于B组(P<0.05或0.01)。B组患者单支病变占比高于A组(P<0.05),两组患者间冠状动脉病变分布情况未见明显差异。术后90 d随访结果显示A组患者不良心血管事件发生率高于B组(P<0.05)。结论AMI合并AF患者较窦性心律AMI患者心力衰竭程度更重,冠状动脉血管病变支数更多,且PCI术后短期心血管不良事件发生率更高,对于此类患者应给予足够的重视及关注。
Objective To analyze the clinical features,distribution characteristics of coronary artery disease(CAD),and short-term prognosis of patients with acute myocardial infarction(AMI)complicated by atrial fibrillation(AF).Methods Clinical data of AMI patients were retrospectively collected,telephone or outpatient follow-ups conducted.Patients were assigned to AF and sinus rhythm(SR)group according to electrocardiogram(ECG)results,such indexes compared between two groups as clinical features,CVD distribution characteristics,occurrence of short-term cardiovascular adverse events,and prognostic outcomes.Results A total of 226 patients were included,of them ones with AMI+AF were 84(group A)and SR+AMI 142(group B).Such indexes as ages,incidences of past myocardial infarction,proportion of patients with KILLIP classⅢ,and left atrial diameter were higher and those as left ventricular ejection fraction(LVEF)and proportion of KILLIP classⅠlower in group A than B(P<0.05 or 0.01).The proportion of single vessel disease was higher in group B than A(P<0.05),intergroup difference in CAD distribution wasn't obvious.Post-operative follow-ups showed that the incidences of cardiovascular adverse events were higher in group A than B.Conclusion Patients with AMI+AF have more severe heart failure,more vessels of the CAD,and higher incidence of short-term cardiovascular adverse events after percutaneous coronary intervention than those with SR+AMI,sufficient attention and care should be given to such patients.
作者
张胜豪
薛斌
姬劲锐
万冬宇
刘恒亮
Zhang Shenghao;Xue Bin;Ji Jinrui;Wan Dongyu;Liu Hengliang(The Fifth Clinical Medical College of Henan University of Chinese Medicine,Zhengzhou 450000,Henan,China)
出处
《临床心身疾病杂志》
CAS
2024年第1期45-49,共5页
Journal of Clinical Psychosomatic Diseases
基金
河南省医学科技攻关计划(编号LHGJ20191068)。
