老年首发急性心肌梗死PCI术后患者发生射血分数保留型心力衰竭的影响因素

Influencing factors of heart failure with preserved ejection fraction in elderly patients with first-spisode acute myocardial infarction after PCI

目的:分析老年首发急性心肌梗死经皮冠状动脉介入(PCI)术后患者发生射血分数保留型心力衰竭(HFpEF)的影响因素。方法:选取2021年5月至2023年4月该院收治的98例行PCI术的老年首发急性心肌梗死患者进行横断面研究,统计老年首发急性心肌梗死PCI术后患者发生HFpEF的情况,采用Logistic回归分析老年首发急性心肌梗死PCI术后患者发生HFpEF的影响因素。结果:98例老年首发急性心肌梗死PCI术后患者发生HFpEF 31例,发生率为31.63%(31/98),设为发生组,其余设为未发生组(n=67);发生组女性、年龄≥65岁、心肌梗死类型为STEMI、卒中史、合并糖尿病、吸烟史、血管病变支数为多支血管病变(MVD)、尿酸(UA)>420μmol/L、氨基末端脑钠肽前体(NT-proBNP)>900 pg/mL等占比均高于未发生组,差异有统计学意义(P<0.05);Logistic回归分析结果显示,女性、年龄≥65岁、合并糖尿病、血管病变支数为MVD、UA>420μmol/L、NT-proBNP>900 pg/mL等均为影响老年首发急性心肌梗死PCI术后患者发生HFpEF的危险因素(OR>1,P<0.05)。结论:年龄≥65岁、女性、合并糖尿病、血管病变支数为MVD、UA>420μmol/L、NT-proBNP>900 pg/mL等均为老年首发急性心肌梗死PCI术后患者发生HFpEF的危险因素。

Objective:To analyze influencing factors of heart failure with preserved ejection fraction(HFpEF)in elderly patients with first-episode acute myocardial infarction after percutaneous coronary intervention(PCI).Methods:A cross-sectional study was conducted on 98 elderly patients with first-episode acute myocardial infarction who underwent PCI in this hospital from May 2021 to April 2023.The occurrence of HFpEF in these elderly patients was statistically analyzed.Logistic regression was used to analyze the influencing factors of HFpEF in the elderly patients with first-episode acute myocardial infarction after PCI.Results:There were 31 cases of HFpEF in the 98 elderly patients with first-episode acute myocardial infarction after PCI,with an incidence of 31.63%(31/98),which were set as the occurrence group,and the rest were set as the nonoccurrence group(n=67).The proportions of the patients of female,age≥65 years,myocardial infarction type STEMI,previous stroke history,combined diabetes mellitus,smoking history,number of vascular lesions as multiple vessel disease(MVD),uric acid(UA)>420μmol/L,N-terminal probrain natriuretic peptide(NT-proBNP)>900 pg/mL in the occurrence group were higher than those in the non-occurrence group,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that female,age≥65 years,combined diabetes mellitus,number of vascular lesions as MVD,UA>420μmol/L,NT-proBNP>900 pg/mL were all risk factors for HFpEF in the elderly patients with first-episode acute myocardial infarction after PCI(OR>1,P<0.05).Conclusions:Age≥65 years,combined diabetes mellitus,number of vascular lesions as MVD,UA>420μmol/L,NT-proBNP>900 pg/mL were all risk factors for HFpEF in the elderly patients with first-episode acute myocardial infarction after PCI.