急性心肌梗死PCI术后非勺型心率与预后

Relationship between non-dipper night rate and prognosis of patients with acute myocardial infarction after PCI

目的探讨夜间非勺型心率与急性心肌梗死(AMI)经皮冠状动脉介入治疗(PCI)术后发生不良心脏事件(MACE)的关系。方法根据24h动态心电监测结果将PCI术后的AMI患者分为夜间非勺型心率组(A组)及夜间勺型心率组(B组)。比较两组患者随访期间主要不良心脏事件(MACE)和再次住院率。结果 A组患者的MACE、心源性死亡、靶血管再次血运重建和再次住院率分别为27.4%、8.1%、14.5%、23.4%,均明显高于B组(p<0.05),但两组的非致死性心肌梗死发生率无显著性差异(4.8%vs 1.2%,p=0.123)。结论夜间非勺型心率有助于早期识别AMI患者PCI术后发生心脏不良事件的高危人群。

Objective The study was to access the association between non-dipper night rate and risk of major adverse cardiovascular events （MACE） in acute myocardial infarction （AMI） patients after percutaneous coronary intervention （PCI）.Methods By monitoring 24-hour heart rate after PCI,patients with AMI were divided into two groups,non-dipper night rate group （group A） and dipper night rate group （group B）.Patients included were prospectively followed-up for MACE for at more than one year.MACE was defined as a composite of cardiac death,nonfatal recurrent myocardial infarction and target vessel revascularization（TVR）.The association between non-dipper night rate and risk of MACE and re-hospitalization due to myocardial ischemia or heart failure during follow-up period was assessed.Results The rates of MACE,cardiac death,TVR and re-hospitalization in group A were 27.4%,8.1%,14.5% and 23.4%,respectively,which were significantly higher than those in group B （p〈0.05）.But there was no significant difference in the incidence of nonfatal myocardial infarction between the two groups （4.8% vs 1.2%,p=0.123）.Conclusions Non-dipper night rate was associated with increased risk of MACE and re-hospitalization in AMI patients after PCI.