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首次急性心肌梗死后射血分数保留患者院内新发心力衰竭的预测因素及预后:一项观察性研究。

Predictors and prognosis for incident in-hospital heart failure in patients with preserved ejection fraction after first acute myocardial infarction: An observational study.

作者信息

Xu Mingzhu, Yan Lihua, Xu Jialiang, Yang Xiangjun, Jiang Tingbo

机构信息

Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou Department of Thoracic and Cardiovascular Surgery, Nantong First People's hospital, The Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China.

出版信息

Medicine (Baltimore). 2018 Jun;97(24):e11093. doi: 10.1097/MD.0000000000011093.

Abstract

Patients with acute myocardial infarction (AMI) complicated by heart failure with preserved ejection fraction (HFpEF) are likely to have more adverse cardiovascular events and higher mortality. The purpose of this study was to examine the predictors and outcomes in AMI patients complicated by HFpEF.We examined the demographics, clinical data, and clinical outcomes in 405 consecutive subjects who firstly presented with AMI after undergoing emergency percutaneous coronary intervention from January 2013 to June 2016.Three hundred twenty patients and eighty-five patients were classified into the nonheart failure (non-HF) group and HFpEF group, respectively. Patients with HFpEF had higher prevalence of prior hypertension, had higher levels of biomarkers, and had a larger left atrial diameter with a nondilated left ventricle were more likely to develop multivessel disease-vessels and had infarction-related artery located in left anterior descending artery than patients without HF. Moreover, patients with HFpEF had a higher probability of developing the in-hospital incident cardiovascular complications and death than non-HF patients.Two routine biomarkers, levels of hypersensitive C-reactive protein and N-terminal-pro brain natriuretic peptide, and number of diseased-vessels were independent predictors for in-hospital HFpEF incidence in AMI patients with preserved LVEF. AMI patients with HFpEF had a higher probability of in-hospital cardiovascular outcomes and mortality.

摘要

急性心肌梗死(AMI)合并射血分数保留的心力衰竭(HFpEF)的患者可能会发生更多不良心血管事件且死亡率更高。本研究的目的是探讨AMI合并HFpEF患者的预测因素及预后情况。我们研究了2013年1月至2016年6月期间405例首次因AMI接受急诊经皮冠状动脉介入治疗的连续受试者的人口统计学、临床资料及临床结局。其中320例和85例患者分别被归入非心力衰竭(non-HF)组和HFpEF组。与无HF的患者相比,HFpEF患者既往高血压患病率更高,生物标志物水平更高,左心房直径更大,左心室未扩张,更易发生多支血管病变,梗死相关动脉位于左前降支。此外,HFpEF患者发生院内心血管并发症及死亡的概率高于non-HF患者。超敏C反应蛋白水平、N末端脑钠肽前体这两种常规生物标志物及病变血管数量是LVEF保留的AMI患者院内发生HFpEF的独立预测因素。合并HFpEF的AMI患者发生院内心血管事件及死亡的概率更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c655/6024188/500fc1386196/medi-97-e11093-g005.jpg

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