初发急性ST段抬高型心肌梗死经皮冠状动脉介入一年内再发急性心脏事件的影响因素分析

Analysis of influencing factors of recurrence of acute cardiac events within one year after initial acute ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention

目的探讨初发急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)1年内再发急性心脏事件的影响因素。方法选取2014年1月至2021年4月首都医科大学附属北京同仁医院收治的初发STEMI并进行PCI的患者,根据术后1年是否再发急性心脏事件分为再发组和对照组,对再发急性心脏事件的影响因素进行单因素和多因素logistic回归分析。结果共纳入159例患者,其中男122例,女37例;对照组112例,再发组47例,1年内再发急性心脏事件的发生率为29.6%。多因素logistic回归分析显示,高龄(OR=1.086,95%CI:1.026~1.150,P=0.005)、卒中史(OR=15.934,95%CI:1.713~148.217,P=0.015)、低Barthel指数评分(OR=0.952,95%CI:0.908~0.998,P=0.042)和高超敏C反应蛋白(hypersensitive C-reactive protein,hsCRP)水平(OR=1.114,95%CI:1.047~1.186,P=0.002)的STEMI患者PCI后1年内再发急性心脏事件的风险较高。结论高龄、卒中史、低Barthel指数评分和高hsCRP水平是STEMI患者PCI后1年内再发急性心脏事件的危险因素,对具有相关危险因素的患者应积极干预随访,以防急性心脏事件的发生。

Objective To explore the influencing factors of recurrent acute cardiac events in patients with initial acute ST-segment elevation myocardial infarction(STEMI)undergoing percutaneous coronary intervention(PCI)within one year.Methods The initial STEMI patients undergoing PCI admitted to Beijing Tongren Hospital,Capital Medical University from January 2014 to April 2021 were selected,and were divided into recurrence group and control group according to the recurrent acute cardiac events or not within one year after operation.The influencing factors of recurrent acute cardiac events were analyzed by univariate and multivariate logistic regression.Results A total of 159 STEMI patients undergoing PCI were included,including 122 males and 37 females.There were 112 cases in the control group and 47 cases in the recurrent group.The incidence of recurrent acute cardiac events within one year was 29.6%.Logistic regression analysis showed that STEMI patients undergoing PCI with older age(OR=1.086,95%CI:1.026-1.150,P=0.005),history of stroke(OR=15.934,95%CI:1.713-148.217,P=0.015),lower Barthel index score(OR=0.952,95%CI:0.908-0.998,P=0.042)and higher hypersensitive C-reactive protein(hsCRP)(OR=1.114,95%CI:1.047-1.186,P=0.002)had a higher risk of recurrence of acute cardiac events within one year.Conclusions Older age,history of stroke,lower Barthel index score and higher hsCRP levels are the risk factors of recurrence of acute cardiac events in STEMI patients undergoing PCI within one year of treatment.Patients with related risk factors should be actively intervened and followed up to prevent the occurrence of acute cardiac events.