Hou Lin-Lin, Gao Chao, Feng Jun, Chen Zhen-Fei, Zhang Jing, Jiang Yong-Jin, Li Xue-Xiang, Wang Bang-Ning
Department of Cardiology, The First Affiliated Hospital of Anhui Medical University.
Department of Cardiology, The Second People Hospital of Hefei.
Tohoku J Exp Med. 2017 May;242(1):27-35. doi: 10.1620/tjem.242.27.
Acute ST segment elevation myocardial infarction (STEMI) is one of the causes of death and disability in patients with cardiovascular diseases. This study aimed to investigate the prognostic factors of in-hospital and long-term survival in patients with acute STEMI undergoing percutaneous coronary intervention (PCI). Patients with STEMI undergoing PCI were divided into the death group (n = 54) and the survival group (n = 306) based on the outcomes during hospitalization. The routine blood and biochemistry tests, Killip classes and global registry of acute coronary events (GRACE) risk score were detected. The 1-, 2- and 3-year survival rates after PCI was observed through a 3-year follow-up. The survival factors, survival rates and multivariate analyses were conducted using Logistic regression analysis, Kaplan-Meier survival analysis and Cox proportional hazards regression. The incidence of cardiogenic shock and anterior wall MI (AWMI), the serum levels of γ-glutamyl endopeptidase (γ-GGT) and creatine kinase isoenzyme MB (CK-MB), Killip classes and GRACE risk score were higher in the death group, compared with the survival group. AWMI, cardiogenic shock, high serum levels of γ-GGT and CK-MB, Killip class III-IV and high GRACE risk scores were associated with in-hospital mortality. AWMI, cardiogenic shock, Killip class III-IV and high GRACE risk scores were correlated with a poor long-term survival. Our findings have demonstrated that AWMI, cardiogenic shock, high serum levels of γ-GGT and CK-MB, Killip class III-IV, and high GRACE risk scores are risk factors for in-hospital and long-term prognosis of acute STEMI patients.
急性ST段抬高型心肌梗死（STEMI）是心血管疾病患者死亡和致残的原因之一。本研究旨在探讨接受经皮冠状动脉介入治疗（PCI）的急性STEMI患者院内及长期生存的预后因素。根据住院期间的结局，将接受PCI的STEMI患者分为死亡组（n = 54）和生存组（n = 306）。检测常规血液和生化检查、Killip分级以及急性冠状动脉事件全球注册（GRACE）风险评分。通过3年随访观察PCI术后1年、2年和3年生存率。采用Logistic回归分析、Kaplan-Meier生存分析和Cox比例风险回归进行生存因素、生存率及多因素分析。与生存组相比，死亡组的心源性休克和前壁心肌梗死（AWMI）发生率、γ-谷氨酰转肽酶（γ-GGT）和肌酸激酶同工酶MB（CK-MB）血清水平、Killip分级及GRACE风险评分更高。AWMI、心源性休克、γ-GGT和CK-MB血清水平升高、Killip分级III-IV级以及GRACE风险评分高与院内死亡率相关。AWMI、心源性休克、Killip分级III-IV级以及GRACE风险评分高与长期生存不良相关。我们的研究结果表明，AWMI、心源性休克、γ-GGT和CK-MB血清水平升高、Killip分级III-IV级以及GRACE风险评分高是急性STEMI患者院内及长期预后的危险因素。
