Zhang Lei, Hailati Juledezi, Ma Xiaoyun, Liu Jiangping, Liu Zhiqiang, Yang Yuchun, He Pengyi, Wulasihan Muhuyati
Department of Comprehensive Cardiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Province, China.
J Int Med Res. 2021 May;49(5):3000605211008326. doi: 10.1177/03000605211008326.
To investigate the different risk factors among different subtypes of patients with acute coronary syndrome (ACS).
A total of 296 patients who had ACS were retrospectively enrolled. Blood and echocardiographic indices were assessed within 24 hours after admission. Differences in risk factors and Gensini scores of coronary lesions among three groups were analyzed.
Univariate analysis of risk factors for ACS subtypes showed that age, and levels of fasting plasma glucose, amino-terminal pro-brain natriuretic peptide, and creatine kinase isoenzyme were significantly higher in patients with non-ST-segment elevation myocardial infarction (NSTEMI) than in those with unstable angina pectoris (UAP). Logistic multivariate regression analysis showed that amino-terminal pro-brain natriuretic peptide and the left ventricular ejection fraction (LVEF) were related to ACS subtypes. The left ventricular end-diastolic diameter was an independent risk factor for UAP and ST-segment elevation myocardial infarction (STEMI) subtypes. The severity of coronary stenosis was significantly higher in NSTEMI and STEMI than in UAP. Gensini scores in the STEMI group were positively correlated with D-dimer levels (r = 0.429) and negatively correlated with the LVEF (r = -0.602).
Different subtypes of ACS have different risk factors. Our findings may have important guiding significance for ACS subtype risk assessment and clinical treatment.
探讨急性冠状动脉综合征（ACS）不同亚型患者的不同危险因素。
回顾性纳入296例ACS患者。入院后24小时内评估血液和超声心动图指标。分析三组患者危险因素及冠状动脉病变Gensini评分的差异。
ACS各亚型危险因素的单因素分析显示，非ST段抬高型心肌梗死（NSTEMI）患者的年龄、空腹血糖水平、氨基末端脑钠肽前体及肌酸激酶同工酶水平显著高于不稳定型心绞痛（UAP）患者。Logistic多因素回归分析显示，氨基末端脑钠肽前体及左心室射血分数（LVEF）与ACS亚型有关。左心室舒张末期内径是UAP和ST段抬高型心肌梗死（STEMI）亚型的独立危险因素。NSTEMI组和STEMI组冠状动脉狭窄程度显著高于UAP组。STEMI组Gensini评分与D-二聚体水平呈正相关（r = 0.429），与LVEF呈负相关（r = -0.602）。
ACS不同亚型有不同的危险因素。我们的研究结果可能对ACS亚型风险评估及临床治疗具有重要指导意义。
