老年急性冠脉综合征患者危险因素与预后分析

Analysis of risk factors and prognosis in elderly patients with acute coronary syndrome

目的探讨老年急性冠脉综合征(ACS)患者传统危险因素与非传统危险因素特点及其与预后关系的分析。方法回顾性分析ACS患者216例,按年龄分为老年组(≥60岁)和非老年组,统计分析2组危险因素个数分布特点及其与预后之间的相关性。传统因素包括性别、低密度脂蛋白胆固醇(LDL-C)>1.8mmol/L、高密度脂蛋白胆固醇(HDL-C)<1.0mmol/L、高血压、糖尿病、吸烟,非传统因素包括三酰甘油(TG)>1.7mmol/L、C反应蛋白(CRP)>2mg/L、前驱糖尿病[空腹血糖5.6～7.0mmol/L或者糖化血红蛋白(HbA1c)>6%]、体质量指数(BMI)>25。结果与非老年组比较,老年组具有的危险因素个数增多(P<0.05),其中老年组中LDL-C>1.8mmol/L、HDL-C<1.0mmol/L、高血压、糖尿病、CRP>2mg/L、前驱糖尿病的比例较非老年组高(P<0.05);而吸烟、TG>150mg/dl、超重的发生率在非老年组较高(P<0.05);ACS老年患者6月主要心脑血管事件(MACCE)发生率随着危险因素个数增多逐渐增高。结论老年ACS患者具有的危险因素个数多,且分布特点与非老年人群不同;随着危险因素个数增加,老年患者发生心脑血管意外的风险相应增加。

Objective To investigate the characteristics of traditional or non-traditional risk factors of acute coronary syndrome（ACS） in elderly patients, and to analyze the relationship between the prognosis and these risk factors. Methods A total of 216 patients with ACS were divided into elderly groups （ ≥60 years old） and non-elderly group. This retrospective analysis was performed to describe the correlations between the numbers of risk factors and the prognosis. The traditional factors included gender, LDL-C 〉 1.8 mrnoL/L, HDL-C 〈 1.0 mmol/L, hypertension, diabetes, smoking, and non- traditional factors included triglycerides 〉 1.7 mmol/L, CRP 〉 2 mg/L, prediabetes （ fasting glucose 5.6-7. 0 mmol/L or HbA1c 〉 6% ）, overweight （BMI 〉 25 ）. Results Compared with the non-elderly group, the number of risk factors was higher in the elderly group（6. 12 vs 3.43, P 〈0. 05）, and the ratio of patients with LDL-C 〉 1.8 mmol/L, HDL-C 〈 1.0 mmoL/L, hypertension, diabetes, CRP 〉 2 mg/L, prediabetes were higher in elderly group （ P 〈 0. 05 ）. While the ratio of smoking, triglycerides 〉 1.7 mmol/L and overweight was higher in non-elderly group （ P 〈 0.05 ）. The incidence of major adverse cardiac and cerebrovascular events（MACCE） in 6 months in patients with ACS increased gradually with the number of the risk factors. Conclusions Elderly patients with ACS have more risk factors, and the distribution characteristics of the risk factors is different from non-elderly patients ; As the number of risk factors increases, the risk of cardiovascular events in elderly patients increases.