Department of Cardiology, Ogaki Municipal Hospital, Ogaki, Japan.
Department of Cardiology, Ogaki Municipal Hospital, Ogaki, Japan; Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Am J Cardiol. 2021 Jun 15;149:9-15. doi: 10.1016/j.amjcard.2021.03.008. Epub 2021 Mar 20.
Knowledge of the long-term prognosis (>10 years) and mortality predictors of ST-elevation myocardial infarction (STEMI) patients who have undergone primary percutaneous coronary intervention (p-PCI) is scarce. Therefore, this study evaluated the long-term prognosis and determined the predictors of long-term outcomes for STEMI patients after p-PCI. Between January, 2006 and December, 2010, we collected data and analyzed 459 consecutive patients with acute STEMI who underwent p-PCI and were discharged from the hospital (mean age, 66.8 years; male, 75.2%; peak creatine phosphokinase level, 2,292.5 IU/L). The primary endpoint was 10-year all-cause mortality. The cumulative 10-year incidence of all-cause death was 23.8%. The Cox multivariate regression analysis identified age ≥ 65 years (adjusted hazard ratio [aHR], p <0.001), body mass index (aHR, 0.93, p = 0.033), presence of atrial fibrillation (aHR, 1.69, p = 0.038), mineralocorticoid receptor antagonist use (aHR, 1.95, p = 0.008), ejection fraction <40% (aHR, 2.14, p = 0.005), and albumin <3.5 g/dL (aHR, 2.01, p = 0.005) as independent predictors of all-cause mortality. In conclusion, a post-discharge 10-year survival rate of 76.2% was identified for STEMI patients who underwent p-PCI.
急性 ST 段抬高型心肌梗死(STEMI)患者行直接经皮冠状动脉介入治疗(p-PCI)后,其长期预后和死亡率预测因素的相关知识十分匮乏。因此,本研究评估了 STEMI 患者行 p-PCI 后的长期预后,并确定了其长期结局的预测因素。2006 年 1 月至 2010 年 12 月,我们连续收集了 459 例接受 p-PCI 治疗且出院的急性 STEMI 患者的数据,并进行了分析(平均年龄 66.8 岁;男性占 75.2%;肌酸磷酸激酶峰值为 2292.5IU/L)。主要终点为 10 年全因死亡率。累积 10 年全因死亡率为 23.8%。Cox 多变量回归分析确定年龄≥65 岁(调整后的危险比 [aHR],p<0.001)、体重指数(aHR,0.93,p=0.033)、心房颤动(aHR,1.69,p=0.038)、使用盐皮质激素受体拮抗剂(aHR,1.95,p=0.008)、射血分数<40%(aHR,2.14,p=0.005)和白蛋白<3.5g/dL(aHR,2.01,p=0.005)是全因死亡率的独立预测因素。总之,STEMI 患者行 p-PCI 后 10 年的出院后生存率为 76.2%。