低T_(3)综合征对老年ST段抬高型心肌梗死患者介入治疗预后的影响

Predictive Value of Low T_(3)Syndrome in Elderly Patients with ST Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention

目的探讨低三碘甲状腺原氨酸(T_(3))综合征与老年急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入(PCI)治疗后1年预后的关系。方法纳入接受急诊PCI治疗的老年STEMI患者455例,依据入院时甲状腺功能分为T_(3)正常组(n=355)和低T_(3)组(n=100)。比较和分析两组患者术后第1、3、6、9和12个月发生主要心血管不良事件(MACEs)的情况,主要终点事件包括:全因死亡、非致命性心肌梗死、靶血管或非靶血管血运重建和心力衰竭。结果在术后1年的随访中,低T_(3)组45例(45.0%)和T_(3)正常组49例(13.8%)患者出现MACEs,差异有统计学意义(P<0.05)。多变量Cox风险回归分析表明,在老年STEMI患者中,低T_(3)综合征与PCI术后MACEs的发生密切相关(HR=3.77,95%CI:2.40~5.91,P<0.05)。结论在老年STEMI患者中,低T_(3)综合征与PCI术后不良预后密切相关。

Objective To investigate the relationship of low triiodothyronine(T_(3))syndrome and one-year prognosis of elderly patients with acute ST elevation myocardial infarction(STEMI)undergoing percutaneous coronary intervention(PCI).Methods A total of 455 elderly patients with STEMI who received primary PCI were enrolled in this study.Patients were divided into normal group(n=355)and low T_(3) group(n=100),according to the thyroid function at admission.Patients were followed up at 1,3,6,9,and 12 months for major adverse cardiovascular events(MACEs).MACE was defined as allcause death,nonfatal myocardial infarction,retarget vessel or non-target vessel revascularization and heart failure.Results During the one-year follow-up,MACEs occurred in 45 patients(45.0%)in low Tgroup and 49(13.8%)in normal T_(3) group(P<0.05).Multivariate Cox proportional hazards regression analysis indicated that low Tstates were independently associated with MACEs in elderly STEMI patients(HR=3.77,95%CI:2.40-5.91,P<0.05).Conclusion Low T_(3) syndrome is strongly associated with poor prognosis in elderly STEMI patients undergoing PCI.