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院外心脏骤停合并ST段抬高型心肌梗死患者的临床特征、管理及预后:来自一项20年注册研究的见解

Clinical Profile, Management, and Outcome in Patients With Out-of-Hospital Cardiac Arrest and ST Segment Elevation Myocardial Infarction: Insights From a 20-Year Registry.

作者信息

Arabi Abdul Rahman, Patel Ashfaq, Al Suwaidi Jassim, Gehani A A, Singh Rajvir, Albinali Hajar A

机构信息

1 Cardiology Department, Heart Hospital, Hamad Medical Corporation (HMC), Doha, Qatar.

2 Cardiology Research Center, Heart Hospital, Doha, Qatar.

出版信息

Angiology. 2018 Mar;69(3):249-255. doi: 10.1177/0003319717699500. Epub 2017 Apr 3.

Abstract

AIM OF THE STUDY

We studied the clinical profile, management, and outcomes of patients with out-of-hospital cardiac arrest (OHCA) with and without ST-elevation myocardial infarction (STEMI).

METHODS

Retrospective analysis of the 20-year registry data (January 1991- June 2010) was conducted on patients with cardiac disease hospitalized at Hamad General Hospital and Qatar Heart Hospital, Doha, Qatar.

RESULTS

A total of 987 patients with OHCA were admitted to the cardiology department during the study period; among them, 296 (30%) patients had STEMI. Compared to the patients with OHCA without STEMI, the patients who had OHCA with STEMI were younger (53 ± 13 vs 58 ± 16 years; P = .001), more likely to be male (78% vs 34%; P = .001), smokers (35% vs 14%) but less likely to have hypertension (30% vs 48%; P = .001), diabetes (32% vs 47%, P = .001), and chronic renal failure (3.4% vs 9%; P = .002). The use of thrombolytic treatment in patients with STEMI increased from 21.6% (period 1991-1095) to 44.4% (period 2006-2010); P = .04.

CONCLUSION

Percutaneous coronary intervention had increased significantly during the last quarter of the study. There was a decline in the in-hospital mortality among patients with STEMI during the last quarter of the study.

摘要

研究目的

我们研究了院外心脏骤停(OHCA)伴或不伴ST段抬高型心肌梗死(STEMI)患者的临床特征、治疗及预后。

方法

对1991年1月至2010年6月期间在卡塔尔多哈哈马德总医院和卡塔尔心脏医院住院的心脏病患者进行了为期20年的登记数据回顾性分析。

结果

在研究期间,共有987例OHCA患者入住心内科;其中,296例(30%)患者患有STEMI。与无STEMI的OHCA患者相比,患有STEMI的OHCA患者更年轻(53±13岁对58±16岁;P = 0.001),男性比例更高(78%对34%;P = 0.001),吸烟者更多(35%对14%),但患高血压(30%对48%;P = 0.001)、糖尿病(32%对47%,P = 0.001)和慢性肾衰竭(3.4%对9%;P = 0.002)的可能性更低。STEMI患者中溶栓治疗的使用率从21.6%(1991 - 1995年期间)增至44.4%(2006 - 2010年期间);P = 0.04。

结论

在研究的最后一个季度,经皮冠状动脉介入治疗显著增加。在研究的最后一个季度,STEMI患者的院内死亡率有所下降。

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