急性冠脉综合征介入治疗后不良心脑血管事件发生状况及相关因素

Analysis of Adverse Cardiac and Cerebral Vascular Events and Related Factors After Interventional Therapy for Acute Coronary Syndrome

目的探讨急性冠状动脉综合征患者经皮冠状动脉介入治疗(PCI)术后主要不良心脑血管事件(MACCE)发生状况及相关因素。方法本研究为回顾性研究,收集2020年12月至2022年2月河南省第二人民医院收治的259例急性冠状动脉综合征患者的临床资料。查阅并统计患者一般资料、相关实验室指标以及术后1 a内MACCE发生情况等。使用Cox生存回归分析检验影响急性冠状动脉综合征患者PCI术后MACCE发生的相关因素。结果259例急性冠状动脉综合征患者PCI术后有41例发生MACCE,占比15.83%。入院收缩压升高、高密度脂蛋白胆固醇(HDL-C)<1.04 mmol·L^(-1)、同型半胱氨酸(Hcy)≥15.00μmol·L^(-1)患者的术后1 a MACCE发生率高于院收缩压正常、HDL-C≥1.04 mmol·L^(-1)、Hcy<15μmol·L^(-1)患者,差异有统计学意义(P<0.05);两组不同年龄、性别、入院舒张压、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、血肌酐(Scr)等术后1 a MACCE发生率比较,差异无统计学意义(P>0.05)。经采用Cox生存回归分析结果显示,入院收缩压、Hcy升高是急性冠状动脉综合征患者PCI术后MACCE发生的危险因素(HR>1,P<0.05),HDL-C升高是其保护因素(HR<1,P<0.05)。结论急性冠状动脉综合征患者PCI术后MACCE的发生受入院收缩压、Hcy、HDL-C等因素影响。

Objective To investigate the incidence and related factors of major adverse cardiac and cerebral vascular events(MACCE)in patients with acute coronary syndrome after percutaneous coronary intervention(PCI).Methods This study was a retrospective study that collected clinical data of 259 patients with acute coronary syndrome admitted to Henan Second Provincial People’s Hospital from December 2020 to February 2022.The patient’s general data,related laboratory indicators occurrence of MACCE within 1 year after operation were reviewed and counted.Cox survival regression analysis was used to test the related factors affecting the occurrence of MACCE after PCI in patients with acute coronary syndrome.Results Forty-one out of 259 patients with acute coronary syndrome experienced MACCE after PCI,accounting for 15.83%.The incidence of MACCE in patients with elevated systolic blood pressure,high density lipoprotein cholesterol(HDL-C)<1.04 mmol·L^(-1),and homocysteinemia(Hcy)≥15.00μmol·L^(-1) was higher than that in patients with normal systolic blood pressure,HDL-C≥1.04 mmol·L^(-1),and Hcy<15μmol·L^(-1),with a statistical significant difference(P<0.05).There was no statistical significant difference in the 1 year incidence of MACCE between two groups with different ages,genders,admission diastolic blood pressure,total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),serum creatinine(Scr),etc(P>0.05).The results of Cox survival regression analysis showed that elevated admission systolic blood pressure and Hcy were risk factors for MACCE after PCI in patients with acute coronary syndrome(HR>1,P<0.05),while elevated HDL-C was a protective factor(HR<1,P<0.05).Conclusion The occurrence of MACCE in patients with acute coronary syndrome after PCI is influenced by factors such as admission systolic blood pressure,Hcy and HDL-C.