摘要
目的分析冠心病伴心力衰竭患者主要不良心血管事件(MACE)发生现状及影响因素。方法选择2020年3月至2022年8月丽水市中心医院心内科收治的366例,依据患者1年随访结果分为发生MACE 102例(观察组)及未发生MACE 264例(对照组)。比较两组患者一般资料、血清指标[心肌肌钙蛋白(cTnI)、氨基末端脑钠肽前体(NT-proBNP)、CRP]以及左心室射血分数(LVEF)。采用ROC曲线分析血清cTnI、NT-proBNP与CRP对冠心病伴心力衰竭患者1年MACE发生的预测效能。采用多因素logistic回归分析冠心病伴心力衰竭患者1年MACE的危险因素。结果观察组纽约心脏病协会(NYHA)心功能分级Ⅲ~Ⅳ级人数占比及cTnI、NT-proBNP、CRP水平均高于对照组,差异均有统计学意义(均P<0.05)。血清cTnI、NT-proBNP与CRP均可用于预测冠心病伴心力衰竭患者1年MACE发生,多因素logistic回归分析显示NYHA心功能分级Ⅲ~Ⅳ级、cTnI≥0.51 ng/mL、NT-proBNP≥3617.46 pg/mL、CRP≥6.43 mg/L均为冠心病伴心力衰竭患者1年MACE的危险因素(均P<0.05)。结论影响冠心病伴心力衰竭患者1年MACE发生的因素较多,其中应密切关注NYHA心功能分级Ⅲ~Ⅳ级、cTnI、NT-proBNP、CRP等指标,尽早采取相关防治措施,改善患者预后。
Objective To analyze the occurrence and influencing factors of major adverse cardiac events(MACEs)in patients with coronary heart disease combined with heart failure.Methods Clinical data of 366 patients with coronary heart disease combined with heart failure admitted to the Department of Cardiology of Lishui Central Hospital from March 2020 to August 2022 were selected.Among them,102 cases with MACE were assigned to the observation group and another 264 cases without MACE were assigned to the control group according to 1-year follow-up results.The general data,serum parameters[cardiac troponin I(cTnI),N terminal B-type brain natriuretic peptide(NT-proBNP),C-reactive protein(CRP)]and left ventricular ejection fraction(LVEF)were compared between the two groups.ROC curve was used to analyze the predictive efficacy of serum cTnI,NT-proBNP and CRP on 1-year MACE in patients with both coronary heart disease and heart failure.Multivariate logistic regression was used to analyze the risk factors for 1-year MACE of patients.Results The proportion of patients graded III-IV in the New York Heart Association(NYHA)heart function grading,and cTnI,NT proBNP,and CRP levels in the observation group were all higher than those of the control group,and the differences were statistically significant(all P<0.05).Serum cTnI,NT proBNP,and CRP can all be used to predict 1-year MACE of patients with both coronary heart disease and heart failure.Multivariate logistic regression analysis showed that NYHA heart function grades III-IV,cTnI≥0.51 ng/mL,NT proBNP≥3617.46 pg/mL,and CRP≥6.43 mg/L were all risk factors for 1-year MACE of patients(P<0.05).Conclusion There are many factors that affect the occurrence of 1-year MACE in patients with both coronary heart disease and heart failure.Among them,close attention should be paid to NYHA heart function gradesⅢ-Ⅳ,cTnI,NT proBNP,CRP and other indicators,and relevant prevention and treatment measures should be taken as soon as possible to improve patient prognosis.
作者
黄杰
刘海威
邹奇霖
HUANG Jie;LIU Haiwei;ZOU Qilin(Department of Cardiology,Lishui Central Hospital,Lishui 323000,China)
出处
《浙江医学》
CAS
2024年第6期625-629,共5页
Zhejiang Medical Journal
关键词
冠心病
心力衰竭
不良心血管事件
心肌肌钙蛋白
C反应蛋白
Coronary heart disease
Heart failure
Adverse cardiovascular events
Cardiac troponin
C-reactive protein
