Yong J W, Wang Z J, Lin X Z, Gao F, Yang L X, Shi D M, Liu Y Y, Zhao Y X, Zhou Y J
Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2019 Mar 24;47(3):209-214. doi: 10.3760/cma.j.issn.0253-3758.2019.03.006.
To analyze the trends on constituent ratio of non-ST-segment-elevation (NSTEMI) and ST-segment-elevation myocardial infarction (STEMI) and related in-hospital mortality in acute myocardial infarction (AMI) patients hospitalized in Beijing Anzhen Hospital from 2004 to 2014. This is a single-center, retrospective study. We reviewed all patients hospitalized for AMI in Beijing Anzhen Hospital from January 1 2004 to December 31 2014, and collected all related information including hospitalization stay, the type of AMI, revascularization and in-hospital mortality. We analyzed the trends of constituent ratio of NSTEMI and STEMI, and their in-hospital mortalities during the 11 years. Data from a total of 23 864 patients with AMI, including 5 539 STEMI and 18 325 NSTEMI, were analyzed. Compared with STEMI patients, NSTEMI patients were older, less likely to be male (0.001), had higher prevalence of hypertension, hyperlipidemia, diabetes (0.001), and lower prevalence of smoking (0.001). Additionally, patients with NSTEMI were more likely to have prior history of MI (12.6% (695/5 539) vs. 7.4% (1 354/18 325), 0.001) and coronary artery bypass graft surgery (2.7% (152/5 539) vs. 0.7% (124/18 325), 0.001). The constituent ratio of NSTEMI was significantly increased during the observation period, rising from 15.8% (107/802) in 2004 to 35.7% (1 273/3 583) in 2014 ( value for trend <0.001). The in-hospital mortality of NSTEMI patients was significantly lower compared with those with STEMI (1.84% (102 cases) vs. 2.74% (502 cases), 0.001). The mortality of both STEMI and NSTEMI were significantly decreased during the 11 years (both value for χ trend test 0.001). After adjusting for other risk factors, NSTEMI was independently associated with lower in-hospital mortality (0.50, 95 0.40-0.63, 0.001). In patients with AMI, the constituent ratio of NSTEMI versus STEMI is increased during the 11 years. The in-hospital mortality is decreased for both STEMI and NSTEMI patients in the past 11 years, and the in-hospital mortality rate of NSTEMI patients is lower than STEMI patients in this patient cohort during the observation period.
分析2004年至2014年在北京安贞医院住院的急性心肌梗死（AMI）患者中非ST段抬高型心肌梗死（NSTEMI）与ST段抬高型心肌梗死（STEMI）的构成比趋势及相关院内死亡率。这是一项单中心回顾性研究。我们回顾了2004年1月1日至2014年12月31日在北京安贞医院因AMI住院的所有患者，并收集了所有相关信息，包括住院时间、AMI类型、血运重建及院内死亡率。我们分析了11年间NSTEMI和STEMI的构成比趋势及其院内死亡率。共分析了23864例AMI患者的数据，其中包括5539例STEMI患者和18325例NSTEMI患者。与STEMI患者相比，NSTEMI患者年龄更大，男性比例更低（P<0.001），高血压、高脂血症、糖尿病患病率更高（P<0.001），吸烟率更低（P<0.001）。此外，NSTEMI患者更可能有心肌梗死病史（12.6%（695/5539）对7.4%（1354/18325），P<0.001）和冠状动脉旁路移植手术史（2.7%（152/5539）对0.7%（124/18325），P<0.001）。观察期内NSTEMI的构成比显著增加，从2004年的15.8%（107/802）升至2014年的35.7%（1273/3583）（趋势P值<0.001）。NSTEMI患者的院内死亡率显著低于STEMI患者（1.84%（102例）对2.74%（502例），P<0.001）。11年间STEMI和NSTEMI的死亡率均显著下降（χ趋势检验P值均为0.001）。在调整其他危险因素后，NSTEMI与较低的院内死亡率独立相关（0.50，95%CI 0.40 - 0.63，P<0.001）。在AMI患者中，11年间NSTEMI与STEMI的构成比增加。过去11年中STEMI和NSTEMI患者的院内死亡率均下降，且在该患者队列观察期内NSTEMI患者的院内死亡率低于STEMI患者。
