ABO血型与急性ST段抬高型心肌梗死患者急诊经皮冠状动脉介入治疗预后的关系

Prognostic value of ABO blood types on patients with acute ST elevation myocardial infarction after primary percutaneous coronary intervention

目的:探讨ABO血型与急性ST段抬高型心肌梗死(STEMI)患者急诊经皮冠状动脉介入治疗(PPCI)预后的关系。方法:收集2006年1月至2012年12月,发病12h内就诊于首都医科大学附属北京安贞医院,接受PPCI的STEMI患者。根据血型检测结果分为两组:非O型血组(n=662)及O型血组(n=220)。记录两组患者的基线资料、血生化指标及造影情况,通过电话及门诊对患者进行定期随访,记录主要不良心血管事件(MACEs):包括心源性死亡、非致死性再发心肌梗死、再发心绞痛。结果:随访期间共发生MACEs189例。两组患者相比,总的MACEs(24.2%vs.13.2%,P=0.001)、再发心肌梗死(7.7%vs.1.8%,P=0.002)及1年内MACEs(8.0%vs.3.2%,P=0.014)在非O型血组患者中的发生率明显高于O型血组。心源性死亡、再发心绞痛及院内死亡发生率,两组间差异无统计学意义。多因素Logistic回归分析发现,非O型血可能是STEMI患者PPCI术后远期MACEs事件的独立预测因子(OR=1.717,95%CI:1.085~2.718,P=0.021)。结论:非O型血可能是STEMI患者PPCI术后远期MACEs事件的独立预测因子。

Objective： To explore the prognostic value ABO blood types on patients with acute ST elevation myocardial infarction （ STEMI ） after primary percutaneous coronary intervention （ PPCI ）. Methods： STEMI patients treated with PPCI within 12 hours from symptom onset admitted to Beijing Anzhen hospital during January 2006 to December 2012 were included in this study. Patients were divided into two groups according to O blood type or non-O blood type. All patients were then followed up. Major adverse cardiac events （MACEs） were recorded. Results： To sum up, 189 MACES were occurred during follow up. The rates of total MACEs （24. 2% vs. 13.2% ,P =0. 001）, re-acute myocardial infarction （7.7% vs. 1.8% ,P = 0. 002） and MACEs with 1 year （8.0% vs. 3.2% ,P =0. 014） were significantly higher in the non-O blood type group. No significant difference was found in terms of cardiac death, re-angina pectoris or in-hospital death between two groups. Multivariate Logistic regression analysis further revealed that non-O blood type was independently associated with long-term total MACEs （ OR = 1. 717,95% CI： 1. 085 -2. 718 ,P = 0. 021 ）. Conclusion： Non-O blood type is an independent predictor of long-term outcomes in patients with STEMI treated with PPCI.