目的:目前关于急性心肌梗死合并恶性肿瘤患者的相关临床资料相对匮乏。本研究主要探讨急性ST段抬高型心肌梗死(STEMI)合并恶性肿瘤的患者的临床特征及预后,以期为这类患者的临床监测、治疗和预后提供临床依据。方法:本研究收集了2021年1...目的:目前关于急性心肌梗死合并恶性肿瘤患者的相关临床资料相对匮乏。本研究主要探讨急性ST段抬高型心肌梗死(STEMI)合并恶性肿瘤的患者的临床特征及预后,以期为这类患者的临床监测、治疗和预后提供临床依据。方法:本研究收集了2021年1月~2021年12月于青岛大学附属烟台毓璜顶医院心内科住院的确诊为急性STEMI的男性吸烟患者。根据合并恶性肿瘤与否,分为合并肿瘤组和未合并肿瘤组。记录并分析研究人群的基线临床资料、冠脉造影结果、肿瘤类型和冠心病二级预防药物等治疗情况。对研究人群随访1年,记录研究终点的发生情况(终点事件包括:全因死亡、再发急性心肌梗死、住院治疗的不稳定型心绞痛、住院治疗的心功能不全)。结果:本研究共收集265例STEMI的男性吸烟患者,其中30例(11.3%)合并恶性肿瘤病史,最终纳入合并肿瘤组30例和未合并肿瘤组65例。在本研究人群中,最常见的恶性肿瘤分别是结直肠癌(20.0%)、肺癌(16.7%)、胃癌(13.3%)和肾癌(10.0%)。与未合并肿瘤组相比,合并肿瘤患者年龄更大(72.60 ± 8.23岁vs 64.06 ± 10.46岁,P Objective: Currently, there is relatively limited clinical data on patients with acute myocardial infarction and malignant tumors. This study mainly explores the clinical characteristics and prognosis of patients with malignant tumors in acute ST segment elevation myocardial infarction (STEMI), in order to provide clinical basis for clinical monitoring, treatment, and prognosis of such patients. Methods: This study collected male smoking patients diagnosed with acute STEMI who were hospitalized in the cardiology department of the Affiliated Yantai Yuhuangding Hospital of Qingdao University from January 2021 to December 2021. According to whether malignant tumors are merged or not, they are divided into tumor group and no tumor group: Record and analyze baseline clinical data, coronary angiography results, tumor types, and treatment status of secondary preventive drugs for coronary heart disease in the study population;follow up the study population for 1 year and record the occurrence of study endpoints (endpoint events include all-cause mortality, recurrent acute myocardial infarction, unstable angina treated in hospital, and cardiac dysfunction treated in hospital). Results: A total of 265 male smokers with acute STEMI were included in this study, of which 30 (11.3%) were complicated with malignant tumors. Ultimately, 30 cases were included in the tumor group and 65 cases were included in the no tumor group. In this study population, the most common malignant tumors were colorectal cancer (20.0%), lung cancer (16.7%), gastric cancer (13.3%), and kidney cancer (10.0%). Compared with the no tumor group, patients with concomitant tumors were older (72.60 ± 8.23 years vs 64.06 ± 10.46 years, P < 0.001), had higher levels of B-type natriuretic peptide [156.01 (73.15, 329.56) vs 55.52 (27.83, 241.25), P = 0.019], and lower levels of hemoglobin (125.17 ± 19.50 vs 142.25 ± 24.34, P = 0.001). In addition, compared with patients without tumors, patients with tumors are more inclined to choose elective surgery at the timing of coronary intervention (60.0% vs 7.7%, P < 0.001). There was no statistically significant difference in the incidence of all-cause mortality, recurrent acute myocardial infarction, unstable angina requiring hospitalization, and heart failure between the 2 groups during a one-year follow-up. Conclusions: Male smokers with acute STEMI combined with malignant tumors have relatively advanced age, higher levels of B-type brain natriuretic peptide and lower levels of hemoglobin, and tend to choose elective surgery at the time of intervention. There is no significant difference in 1-year clinical prognosis between the 2 groups.展开更多
目的:探讨房颤患者血清CCN5水平是否可以预测左房低电压面积(LVZ)的大小。方法:选取2023年6月到2024年1月于烟台毓璜顶医院就诊的窦性心律患者(对照组) 79例以及首次接受心脏射频消融术的房颤患者(房颤组)114例。收集一般资料、生化、...目的:探讨房颤患者血清CCN5水平是否可以预测左房低电压面积(LVZ)的大小。方法:选取2023年6月到2024年1月于烟台毓璜顶医院就诊的窦性心律患者(对照组) 79例以及首次接受心脏射频消融术的房颤患者(房颤组)114例。收集一般资料、生化、心电图、心脏超声等临床资料。按术中行基质电压标测所得的LVZ是否大于6%将患者分为A组(LVZ Objective: To explore whether the serum CCN5 levels associated with atrial fibrosis can predict LVZ in patients with atrial fibrillation. Methods: In this study, 79 patients with sinus rhythm (control group) and 114 patients with atrial fibrillation (atrial fibrillation group) who received radiofrequency cardiac ablation for the first time in Yantai Yuhuangding Hospital between June 2023 and January 2024 were enrolled. General data, biochemistry, electrocardiogram, cardiac ultrasound and other clinical data were collected. Left atrial stroma voltage mapping was performed in patients with atrial fibrillation and LVZ area ratio was calculated. Patients were divided into group A (LVZ < 6%) and group B (LVZ ≥ 6%) according to whether LVZ was greater than 6%. The expression level of CCN5 in peripheral blood was measured by enzyme-linked immunosorbent assay. T test was used to compare the CCN5 expression level between the control group and the atrial fibrillation group. Pearson or Spearman correlation analysis was used to explore the correlation between CCN5 and clinical data. Binary Logistic regression analysis was used to determine the risk factors affecting the LVZ, and receiver operating characteristic (ROC) analysis was down to determine the cut-off value of CCN5 to predict LVZ. Results: The level of CCN5 in patients with atrial fibrillation was lower than in control group (32.43 ± 6.15 vs. 25.46 ± 4.97, P < 0.001). For atrial fibrillation patients with LVZ < 6%, blood CCN5 expression levels were lower in patients with LVZ ≥ 6% (30.10 ± 6.75 vs. 24.75 ± 3.49, P < 0.001). In patients with atrial fibrillation, CCN5 was negatively correlated with BNP level, left atrial diameter and left atrial low-voltage area ratio (P < 0.05). Logistic regression analysis suggested that blood CCN5 level was an independent risk factor for LVZ. ROC curve showed that in patients with atrial fibrillation, the optimal blood concentration of CCN5 to predict LVZ ≥ 6% was 27.22 ng/ml, sensitivity was 0.707, specificity was 0.773, and area under the curve was 0.785 [P < 0.001, CI: (0.696, 0.873)]. Conclusion: Serum CCN5 can independently predict the proportion of left atrial low-voltage area in patients with atrial fibrillation.展开更多
文摘目的:目前关于急性心肌梗死合并恶性肿瘤患者的相关临床资料相对匮乏。本研究主要探讨急性ST段抬高型心肌梗死(STEMI)合并恶性肿瘤的患者的临床特征及预后,以期为这类患者的临床监测、治疗和预后提供临床依据。方法:本研究收集了2021年1月~2021年12月于青岛大学附属烟台毓璜顶医院心内科住院的确诊为急性STEMI的男性吸烟患者。根据合并恶性肿瘤与否,分为合并肿瘤组和未合并肿瘤组。记录并分析研究人群的基线临床资料、冠脉造影结果、肿瘤类型和冠心病二级预防药物等治疗情况。对研究人群随访1年,记录研究终点的发生情况(终点事件包括:全因死亡、再发急性心肌梗死、住院治疗的不稳定型心绞痛、住院治疗的心功能不全)。结果:本研究共收集265例STEMI的男性吸烟患者,其中30例(11.3%)合并恶性肿瘤病史,最终纳入合并肿瘤组30例和未合并肿瘤组65例。在本研究人群中,最常见的恶性肿瘤分别是结直肠癌(20.0%)、肺癌(16.7%)、胃癌(13.3%)和肾癌(10.0%)。与未合并肿瘤组相比,合并肿瘤患者年龄更大(72.60 ± 8.23岁vs 64.06 ± 10.46岁,P Objective: Currently, there is relatively limited clinical data on patients with acute myocardial infarction and malignant tumors. This study mainly explores the clinical characteristics and prognosis of patients with malignant tumors in acute ST segment elevation myocardial infarction (STEMI), in order to provide clinical basis for clinical monitoring, treatment, and prognosis of such patients. Methods: This study collected male smoking patients diagnosed with acute STEMI who were hospitalized in the cardiology department of the Affiliated Yantai Yuhuangding Hospital of Qingdao University from January 2021 to December 2021. According to whether malignant tumors are merged or not, they are divided into tumor group and no tumor group: Record and analyze baseline clinical data, coronary angiography results, tumor types, and treatment status of secondary preventive drugs for coronary heart disease in the study population;follow up the study population for 1 year and record the occurrence of study endpoints (endpoint events include all-cause mortality, recurrent acute myocardial infarction, unstable angina treated in hospital, and cardiac dysfunction treated in hospital). Results: A total of 265 male smokers with acute STEMI were included in this study, of which 30 (11.3%) were complicated with malignant tumors. Ultimately, 30 cases were included in the tumor group and 65 cases were included in the no tumor group. In this study population, the most common malignant tumors were colorectal cancer (20.0%), lung cancer (16.7%), gastric cancer (13.3%), and kidney cancer (10.0%). Compared with the no tumor group, patients with concomitant tumors were older (72.60 ± 8.23 years vs 64.06 ± 10.46 years, P < 0.001), had higher levels of B-type natriuretic peptide [156.01 (73.15, 329.56) vs 55.52 (27.83, 241.25), P = 0.019], and lower levels of hemoglobin (125.17 ± 19.50 vs 142.25 ± 24.34, P = 0.001). In addition, compared with patients without tumors, patients with tumors are more inclined to choose elective surgery at the timing of coronary intervention (60.0% vs 7.7%, P < 0.001). There was no statistically significant difference in the incidence of all-cause mortality, recurrent acute myocardial infarction, unstable angina requiring hospitalization, and heart failure between the 2 groups during a one-year follow-up. Conclusions: Male smokers with acute STEMI combined with malignant tumors have relatively advanced age, higher levels of B-type brain natriuretic peptide and lower levels of hemoglobin, and tend to choose elective surgery at the time of intervention. There is no significant difference in 1-year clinical prognosis between the 2 groups.
文摘目的:探讨房颤患者血清CCN5水平是否可以预测左房低电压面积(LVZ)的大小。方法:选取2023年6月到2024年1月于烟台毓璜顶医院就诊的窦性心律患者(对照组) 79例以及首次接受心脏射频消融术的房颤患者(房颤组)114例。收集一般资料、生化、心电图、心脏超声等临床资料。按术中行基质电压标测所得的LVZ是否大于6%将患者分为A组(LVZ Objective: To explore whether the serum CCN5 levels associated with atrial fibrosis can predict LVZ in patients with atrial fibrillation. Methods: In this study, 79 patients with sinus rhythm (control group) and 114 patients with atrial fibrillation (atrial fibrillation group) who received radiofrequency cardiac ablation for the first time in Yantai Yuhuangding Hospital between June 2023 and January 2024 were enrolled. General data, biochemistry, electrocardiogram, cardiac ultrasound and other clinical data were collected. Left atrial stroma voltage mapping was performed in patients with atrial fibrillation and LVZ area ratio was calculated. Patients were divided into group A (LVZ < 6%) and group B (LVZ ≥ 6%) according to whether LVZ was greater than 6%. The expression level of CCN5 in peripheral blood was measured by enzyme-linked immunosorbent assay. T test was used to compare the CCN5 expression level between the control group and the atrial fibrillation group. Pearson or Spearman correlation analysis was used to explore the correlation between CCN5 and clinical data. Binary Logistic regression analysis was used to determine the risk factors affecting the LVZ, and receiver operating characteristic (ROC) analysis was down to determine the cut-off value of CCN5 to predict LVZ. Results: The level of CCN5 in patients with atrial fibrillation was lower than in control group (32.43 ± 6.15 vs. 25.46 ± 4.97, P < 0.001). For atrial fibrillation patients with LVZ < 6%, blood CCN5 expression levels were lower in patients with LVZ ≥ 6% (30.10 ± 6.75 vs. 24.75 ± 3.49, P < 0.001). In patients with atrial fibrillation, CCN5 was negatively correlated with BNP level, left atrial diameter and left atrial low-voltage area ratio (P < 0.05). Logistic regression analysis suggested that blood CCN5 level was an independent risk factor for LVZ. ROC curve showed that in patients with atrial fibrillation, the optimal blood concentration of CCN5 to predict LVZ ≥ 6% was 27.22 ng/ml, sensitivity was 0.707, specificity was 0.773, and area under the curve was 0.785 [P < 0.001, CI: (0.696, 0.873)]. Conclusion: Serum CCN5 can independently predict the proportion of left atrial low-voltage area in patients with atrial fibrillation.
