老年急性心肌梗死患者梗死前心绞痛与临床预后的关系(附78例分析)

Relationship between preinfarction angina and clinical outcome of elderly patients with acute myocardial infarction and clinical:Analysis of 78 cases

目的评估老年急性心肌梗死(AMI)患者梗死前心绞痛(PIA)与临床预后之间的关系。方法78例ST段抬高型AMI患者分为两组:A组46例PIA患者与B组32例无PIA患者。观察两组基础临床情况、梗死后心绞痛、心衰、住院期间及随访30天主要心脏不良事件(MACE,死亡/再梗死/再次靶血管重建)发生率。结果78例患者平均年龄71.5岁,男52例(66.7%),女26例(33.3%)。伴随高血压患者62例(79.4%),糖尿病17例(21.8%),高脂血症19例(24.4%)。心功能KillipⅠ级58例(74.3%)。A、B两组病人临床终点事件比较:梗死后心绞痛发生率(9.5%与20%,P=0.63);心衰发生率(23.6%与13.1%,P=0.67);住院期间及随访30天,MACE发生率(4.3%与3.1%,P=1.00)。结论本组研究认为老年AMI患者梗死前心绞痛与临床预后无明显相关性。

Objective To assess the relationship between PIA and the clinical outcome of elderly patients with acute myocardial infarction （AMI）. Methods Senventy-eight patients with ST-segment elevation AMI were divided into two groups： group A （46 patients with PIA） and group B （32 patients without PIA）. The incidence of post infarction angina, heart failure, and the rate of MACE （major adverse cardiac events） during hospital and 30 days follow up were observed. Results Mean age of the study population was 71.5 years, and there was a predominance of males （66.7%）. Hypertension was present in 79.4%, diabetes in 21.8% and dyslipidemia in 24. 4%, and the majority of them （74.3%） were in Killip class I. Clinical end- points for groups A and B were as follows： postinfarction angina （9.5% versus 20%, P=0. 630） ; heart failure （23.6% versus13.1%, P=0.674）; the rate of MACE （4.3%versus3.1%, P=1.00）. Conclusions The study showed that there is no evident relationship between PIA and the clinical outcome of elderly patients with AMI.