Department of Cardiology, The Second Affiliated Hospital, 74626Guangxi Medical University, Nanning, Guangxi, People's Republic of China.
Department of Cardiology, Institute of Cardiovascular Diseases, The First Affiliated Hospital, 74626Guangxi Medical University, Nanning, Guangxi, People's Republic of China.
Clin Appl Thromb Hemost. 2020 Jan-Dec;26:1076029620950837. doi: 10.1177/1076029620950837.
Acute myocardial infarction (AMI) is a leading cause of death and not a few of these patients are combined with acidemia. This study aimed to detect the association of acidemia with short-term mortality of AMI patients. A total of 972 AMI patients were selected from the Medical Information Mart for Intensive Care (MIMIC) III database for analysis. Propensity-score matching (PSM) was used to reduce the imbalance. Kaplan-Meier survival analysis was used to compare the mortality, and Cox-proportional hazards model was used to detect related factors associated with mortality. After PSM, a total of 345 non-acidemia patients and 345 matched acidemia patients were included. The non-acidemia patients had a significantly lower 30-day mortality (20.0% vs. 28.7%) and lower 90-day mortality (24.9% vs. 31.9%) than the acidemia patients ( < 0.001 for all). The severe-acidemia patients (PH < 7.25) had the highest 30-day mortality (52.6%) and 90-day mortality (53.9%) than non-acidemia patients and mild-acidemia (7.25 ≤ PH < 7.35) patients ( < 0.001). In Cox-proportional hazards model, acidemia was associated with improved 30-day mortality (HR = 1.518; 95%CI = 1.110-2.076, = 0.009) and 90-day mortality (HR = 1.378; 95%CI = 1.034 -1.837, = 0.029). These results suggest that severe acidemia is associated with improved 30-day mortality and 90-day mortality of AMI patients.
急性心肌梗死（AMI）是主要的死亡原因之一，其中不少患者伴有酸中毒。本研究旨在探讨酸中毒与 AMI 患者短期死亡率的关系。从 Medical Information Mart for Intensive Care (MIMIC) III 数据库中选取 972 例 AMI 患者进行分析。采用倾向评分匹配（PSM）来减少不平衡。Kaplan-Meier 生存分析比较死亡率，Cox 比例风险模型检测与死亡率相关的因素。PSM 后，共纳入 345 例非酸中毒患者和 345 例匹配的酸中毒患者。非酸中毒患者 30 天死亡率（20.0% vs. 28.7%）和 90 天死亡率（24.9% vs. 31.9%）明显低于酸中毒患者（均<0.001）。严重酸中毒患者（PH<7.25）30 天死亡率（52.6%）和 90 天死亡率（53.9%）最高，高于非酸中毒患者和轻度酸中毒（7.25≤PH<7.35）患者（均<0.001）。在 Cox 比例风险模型中，酸中毒与 30 天死亡率（HR=1.518；95%CI=1.110-2.076， =0.009）和 90 天死亡率（HR=1.378；95%CI=1.034-1.837， =0.029）改善相关。这些结果表明，严重酸中毒与 AMI 患者 30 天和 90 天死亡率的改善相关。
