急性非ST段抬高型心肌梗死患者PCI术后发生MACE的危险因素  

Risk Factors for MACE After PCI in Patients with Acute Non-ST-Segment Elevation Myocardial Infarction

作　　者：徐畅 李伊旻 窦镜申 蒋廷波[1] XU Chang;LI Yimin;DOU Jingshen;JIANG Tingbo(Cardiology Department,the First Affiliated Hospital of Soochow University,Suzhou 215006,China)

机构地区：[1]苏州大学附属第一医院心内科,江苏苏州215006

出　　处：《河南医学研究》2024年第18期3274-3277,共4页Henan Medical Research

摘　　要：目的探讨急性非ST段抬高型心肌梗死(NSTEMI)患者经皮冠状动脉介入治疗(PCI)术后1 a内发生主要不良心血管事件(MACE)的危险因素。方法回顾性收集2019年1月至2022年1月苏州大学附属第一医院心内科收治住院的213例NSTEMI患者的临床资料。通过门诊及电话进行随访,根据随访结果分为非MACE组(未发生MACE,170例)、MACE组(发生MACE,43例),并对两组进行单因素和多因素分析,探讨NSTEMI患者PCI术后发生MACE的独立危险因素。结果单因素分析显示,MACE组患者高血压、糖尿病、病变支数≥2支占比升高,入院时全球急性冠状动脉事件注册(GRACE)风险评分、红细胞分布宽度(RDW)、凝血酶原时间(PT)较非MACE组升高,入院时血红蛋白、总胆固醇(TC)水平较非MACE组降低(P<0.05)。二元logistic回归分析显示,患者病变支数≥2支(OR=2.172,95%CI:1.291~3.653,P<0.05)、GRACE风险评分(OR=1.035,95%CI:1.019~1.050,P<0.05)、糖尿病(OR=2.705,95%CI:1.114~6.567,P<0.05)和RDW值(OR=2.145,95%CI:1.250~3.681,P<0.05)是NSTEMI患者PCI术后发生MACE的独立危险因素。受试者工作特征曲线结果显示,GRACE风险评分的曲线下面积为0.799(P<0.001),截断值为147.5分;RDW值的曲线下面积为0.693(P<0.001),截断值为13.05%。结论患者病变支数≥2支、GRACE风险评分、患有糖尿病、RDW水平升高为NSTEMI患者PCI术后发生MACE事件的独立危险因素。高血压、血红蛋白、TC、及PT水平对MACE的发生具有一定的预测价值。Objective To discuss the risk factors for major adverse cardiovascular events(MACE)within 1 years after percutaneous coronary intervention(PCI)in acute non-ST-segment elevation myocardial infarction(NSTEMI).Methods The clinical data of 213 NSTEMI patients admitted to the Cardiology Department of the First Affiliated Hospital of Soochow University from January 2019 to January 2022 were collected.All patients were followed up through outpatient clinics and telephone,and they were divided into non-MACE group(without MACE,170 cases)and MACE group(with MACE,43 cases)according to the follow up results.And single and multivariate analysis was conducted on two groups to explore the independent risk factors for MACE after PCI in NSTEMI patients.Results Single factor analysis showed that the proportion of hypertension,diabetes and the number of diseased branches≥2 increased in the MACE group,and the global registration of acute coronary events(GRACE)risk score,red blood cell distribution width(RDW),prothrombin time(PT)at admission were higher than those in the non-MACE group,while the hemoglobin and total cholesterol(TC)levels at admission were lower than those in the non-MACE group(P<0.05).The results of binary logistic regression analysis showed that the number of diseased branches≥2(OR=2.172,95%CI:1.291-3.653,P<0.05),GRACE risk score(OR=1.035,95%CI:1.019-1.050,P<0.05),diabetes(OR=2.705,95%CI:1.114-6.567,P<0.05)and RDW(OR=2.145,95%CI:1.250-3.681,P<0.05)were independent risk factors for MACE in NSTEMI patients after PCI.The results of receiver operating characteristic curve analysis showed that the area under the curve of GRACE risk score was 0.799(P<0.001)and cut-off value was 147.5 points,the area under the curve of RDW was 0.693(P<0.001)and cut-off value was 13.05%.Conclusion The number of diseased branches≥2,GRACE score,diabetes and increased RDW level are independent risk factors for the occurrence of MACE events in NSTEMI patients after PCI.Hypertension,hemoglobin,TC and PT levels have certain predictive value

关 键 词：急性非ST段抬高型心肌梗死 经皮冠状动脉介入治疗 主要不良心血管事件 危险因素 

分 类 号：R542.22[医药卫生—心血管疾病]