Holovanova Iryna A, Oksak Grygori A, Tkachenko Iryna M, Khorosh Maxim V, Tovstiak Mariia M, Strashko Yevhen Yu
Ukrainian Medical Stomatological Academy, Poltava, Ukraine.
Wiad Lek. 2020;73(6):1245-1251.
The aim of our study was to identify the main risk factors for the occurrence of early complications of acute myocardial infarction after cardio-interventional treatment and to evaluate prognostic risk indicators.
Materials and methods: Risk factors of myocardial infarction were determined by copying the case history data and calculating on their basis of the odds ratio and ±95% confidence interval. After it, we made a prediction of the risk of early complications of AMI with cardiovascular intervention by using a Cox regression that took into account the patient's transportation time by ambulance.
Results: Thus, the factors that increase the chances of their occurrence were: summer time of year; recurrent myocardial infarction of another specified localization (I122.8); the relevance of the established STEMI diagnosis; diabetes mellitus; renal pathology; smoking; high rate of BMI. Factors that reduce the chances of their occurrence: men gender - in 35%; the age over of 70 - by 50%; the timely arrival of an emergency medical team - by 55%. The factors that increase the chances of their occurrence were: age over 70 years; subsequent myocardial infarction of unspecified site; diabetes mellitus. Using of a Cox regression analysis, it was proved that the cumulative risk of early complications of AMI with cardio-intervention treatment increased from the 10th minute of ambulance arrival at place, when ECG diagnosis (STEMI), presence of diabetes mellitus, smoking and high BMI.
Conclusions: As a result of the conducted research, the risk factors for early complications of AIM with cardio-interventional treatment were identified.
本研究旨在确定心脏介入治疗后急性心肌梗死早期并发症发生的主要危险因素,并评估预后风险指标。
材料与方法:通过复制病历数据并基于比值比和±95%置信区间进行计算来确定心肌梗死的危险因素。之后,我们使用Cox回归对急性心肌梗死心血管介入治疗早期并发症的风险进行预测,该回归考虑了患者的救护车转运时间。
结果:因此,增加其发生几率的因素有:一年中的夏季;另一个特定部位的复发性心肌梗死(I122.8);已确立的ST段抬高型心肌梗死诊断的相关性;糖尿病;肾脏病变;吸烟;高体重指数。降低其发生几率的因素有:男性——降低35%;70岁以上——降低50%;急救医疗队及时到达——降低55%。增加其发生几率的因素有:70岁以上;未指定部位的后续心肌梗死;糖尿病。使用Cox回归分析证明,当心电图诊断为(ST段抬高型心肌梗死)、存在糖尿病、吸烟和高体重指数时,心脏介入治疗的急性心肌梗死早期并发症的累积风险从救护车到达现场的第10分钟开始增加。
结论:通过开展的研究,确定了心脏介入治疗急性心肌梗死早期并发症的危险因素。