摘要
目的 分析预测非ST段抬高急性冠状动脉综合征(ACS)患者30天内发生心血管事件的独立危险因素。方法 根据283例非ST段抬高ACS患者就诊即刻的临床情况、心电图变化和心肌生化标志物水平,判断预测30天内急性心血管事件的独立危险因素;急性心血管事件的定义为死亡、恶性室性心律失常、再发心肌梗死和心绞痛、急性左心功能衰竭、需重复经皮冠状动脉成形术(PTCA)或冠状动脉旁路移植术(CABG)或再次住院。结果 共33例患者(11.7%)发生急性心血管事件;多因素分析发现30天内心血管事件的独立预测因素包括高龄(OR=1.39,95%CI 1.13~1.82,P=0.006)、糖尿病史(OR=2.21,95%CI 1.29~3.79,P=0.013)、就诊时心电图ST段压低(OR=2.49,95%CI 1.26~3.98,P=0.004)、就诊12小时内心肌生化标志物阳性(OR=2.84,95%CI 1.42~5.38,P=0.003)。结论 年龄增加、糖尿病、就诊即刻心电图ST段压低和就诊12小时以内心肌特异性酶学改变(CK-MB或TNT)4项因素是非ST段抬高ACS患者在30天内发生急性心血管事件的独立预测因素。
Objective To determine the independent factors of major adverse cardiovascular events (MACE) within 30 days of presentation in patients with non-ST elevation acute coronary syndrome (ACS). Methods This was a prospectively designed cohort study including 283 patients with unstable angina pectoris or non-ST elevations ACS.The data of presentation and the MACE were recorded within 30 days of follow-up. Death, malignant ventricular arythmia, acute heart failure, revascularization and rehospitalization were defined as MACE. Results MACE took place in 33 patients ((11.7)%). Multiple logistic regression analysis identified four presenting clinical factors predicted the 30-day MACE:① age[odds ratio(OR),(1.39); 95% confidence interval(CI), (1.13)-(1.82),P=(0.006))]; ② diabetes (OR, (2.21); 95%CI, (1.29)-(3.79),P=(0.013)); ③ baseline ST depression(OR, (2.49); 95%CI, (1.26)-(3.98),P=(0.004)); ④ myocardial enzymes positive within 12 hours of presentation (OR, (2.84); 95% CI, (1.42)-(5.38), P=(0.003)). Conclusion The prospectively designed cohort study identified age, diabetes, baseline ST depression, myocardial enzymes positive within 12 hours of presentation are the predictors of MACE within 30 day of presentation.
出处
《临床荟萃》
CAS
北大核心
2005年第16期901-904,共4页
Clinical Focus
关键词
冠状动脉疾病
心电描记术
因素分析
统计学
随访研究
coronary disease
electrocardiography
factor analysis,statistical
follow-up studies