急性心肌梗死合并早发或晚发心房颤动的临床及冠状动脉病变特点分析

Comparison of clinical and coronary angiographic characteristics in acute myocardial infarction patients with new-onset atrial fibrillation in early or later stages

目的观察急性心肌梗死(AMI)合并早发或晚发心房颤动(房颤)的临床及冠状动脉病变特点。方法分析自2010年6月至2013年6月1358例AMI住院患者,经确诊为AMI合并新发房颤患者88例,根据房颤发生的时间是否在入院24 h以内,分为早发房颤组40例、晚发房颤组48例,比较两组临床特征、冠状动脉病变的差异。结果早发房颤组下壁心肌梗死的比例较高,而晚发房颤组前壁心肌梗死的比例较高(P<0.05);晚发房颤组冠状动脉三支病变、Killip心功能≥2级的发生率及住院期病死率均高于早发房颤组(P<0.05)。结论 AMI合并新发房颤的发生时间与患者的临床特征、梗死相关动脉及预后有关系,可作为评估AMI病情及预后的参考指标。

Objective To explore the clinical and coronary angiographic characteristics in acute myocardial infarction （AMI） patients with new-onset atrial ifbrillation in early or later stages. Methods From Jun. 2010 to Jun. 2013, 1358 cases of AMI were hospitalized in which 88 were proved to have AMI complicated with new-onset atrial ifbrillation. Eligible patients were divided into early onset group （group1, n=40 cases） and the later onset group （group2, n=48 cases） according to the occurrence of atrial ifbrillation within or after 24 hours of admission. The clinical characteristics and the pathological changes of coronary arteries of the two groups were compared respectively. Results The incidence of inferior wall AMI was signiifcantly higher in group 1. The incidence of anterior wall AMI was signiifcantly higher in group 2 （P〈0.05）. The incidence of congestive heart failure, the incidence of three-vessel lesions and the in-hospital mortality in group 2 were higher than which in group 1 （P 〈 0.05）. Conclusions The new-onset atrial ifbrillation in different stages may be regarded as a useful indicator for evaluating the clinical characteristic and the infarct-related coronary artery lesions and prognosis of patients with AMI.