摘要
目的 分析早发心肌梗死及非早发心肌梗死危险因素差异及血运重建术后1年预后。方法 选取2018年9月1日至2020年11月30日在上海交通大学医学院附属第六人民医院南院住院的心肌梗死患者,分为早发心肌梗死组(男性≤50岁、女性≤60岁)、非早发心肌梗死组(男性>50岁、女性>60岁),比较两组临床资料、血生化及超声心动图检查结果,对入组患者电话或返院随访1年,观察两组在住院期间及血运重建术后1年的预后情况。结果 与非早发心肌梗死组比较,早发心肌梗死组高血压及糖尿病占比、高密度脂蛋白胆固醇、肌酐、糖化血红蛋白、脑钠肽较低(P均<0.05),而血红蛋白、血小板计数、甘油三酯、丙氨酸转氨酶、估算肾小球滤过率、左室射血分数较高(P均<0.05);logistic回归分析显示血小板计数增加、甘油三酯升高、高密度脂蛋白胆固醇降低与早发心肌梗死相关。随访1年发现,早发心肌梗死组心力衰竭发病率较低(P<0.05),而出血事件发生率较高(P<0.05)。早发心肌梗死组的高血压、糖尿病患病率较低,肾功能较好,血运重建术后1年预后较好,但出血风险较高。结论 血脂异常(特别是甘油三酯及高密度脂蛋白)、血小板计数增多为早发心肌梗死的独立危险因素,早发心肌梗死患者完全血运重建后短期预后优于非早发心肌梗死患者。
Objective To analyze the differences of risk factors between premature myocardial infarction(MI) and non-premature MI, and follow-up to observe the prognosis 1-year after cardiac revascularization. Methods Enrolled patients with myocardial infarction hospitalized in Shanghai Jiao Tong University School of Medicine Affiliated Sixth People′s Hospital South Campus from September 1, 2018 to November 30, 2020. They were divided into two group: the young MI(premature MI) group and the non-young MI group. The basic clinical data, blood test and echocardiography of the two groups were compared. The patients were followed up by telephone or in hospital. The prognosis of the two groups during hospitalization and 1 year after cardiac revascularization were compared. Results Compared with non-young MI group, the proportion of hypertension and diabetes, high density lipoprotein-cholesterol(HDL-C), creatinine(Cr), glycosylated hemoglobin(HbA1C), B-type natriuretic peptide(BNP) were lower in young MI group(all P<0.05), but hemoglobin, platelet count, triglyceride, alanine aminotransferase, estimated glomerular filtration rate(eGFR) and left ventricular ejection fraction(LVEF) in young MI group were higher(all P<0.05). One year follow-up showed that the incidence rate of heart failure in the young MI group was lower than that in the non-young MI group(P<0.05), while the incidence rate of bleeding events in the young MI group was higher(P<0.05). There was no significant difference in other major cardiovascular and cerebrovascular events between the two groups. The prevalence of hypertension and diabetes in the young MI group was lower than that in the non-young MI group. Renal function decreased significantly in non-young MI group. The young MI group may had a better prognosis one year after revascularization, but had a higher risk of bleeding.Conclusion Hypertriglyceridemia, low level of HDL-C,more platelet count were risk factors for young MI. Abnormal blood lipids( especially triglycerides and high-density lipoprotein) and e
作者
孙艳转
许宜冠
乔增勇
王宏伟
SUN Yanzhuan;XU Yiguan;QIAO Zengyong;WANG Hongwei(Department of Cardiology,Shanghai Jiao Tong University School of Medicine Afiliated Sixth People's Hospital South Campus,Shanghai 200333,China;Department of Cardiology,Shanghai Putuo District People's Hospital,Shanghai 20060,China)
出处
《中国分子心脏病学杂志》
CAS
2024年第1期5838-5843,共6页
Molecular Cardiology of China
基金
上海市科学技术委员会科研计划项目(19JC1415704)
上海市奉贤区科学技术委员会面上项目(20201615)。
关键词
早发心肌梗死
心肌梗死
血运重建
预后
Myocardial infarction in young adults
Myocardial infarction
Cardiac revascularization
Prognosis
