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高血压合并高同型半胱氨酸血症的急性心肌梗死患者的结局。

The outcomes of acute myocardial infarction patients comorbidity with hypertension and hyperhomocysteinemia.

机构信息

Department of Cardiology, The First Affiliated Hospital of Nanchang University, 17 Yongwaizheng St, Nanchang, 330006, Jiangxi, China.

出版信息

Sci Rep. 2021 Nov 25;11(1):22936. doi: 10.1038/s41598-021-02340-w.

Abstract

This study investigated the outcomes and major adverse cardiovascular events (MACEs) incurred by acute myocardial infarction (AMI) patients comorbiding with hypertension and hyperhomocysteinemia (HHcy) during hospitalization and 1-year follow-up. 648 consecutive AMI patients were divided into four categories: (1) hypertension with Hcy ≥ 15 µmol/L; (2) hypertension with Hcy < 15 µmol/L; (3) no-hypertension with Hcy ≥ 15 µmol/L; (4) no-hypertension with Hcy < 15 µmol/L. Information taken from these case files included gender, past medical history, vital signs, laboratory examination, electrocardiogram, coronary angiography, cardiac ultrasound, and medicine treatment. The primary endpoints were duration of coronary care units (CCU) stay, duration of in-hospital stay, and MACEs during follow-up. Our data show that hypertension and HHcy have a synergistic effect in AMI patients, AMI comorbiding with hypertension and HHcy patients had more severe multi-coronary artery disease and more frequent non-culprit coronary lesions complete clogging, had a higher prevalence of pro-brain natriuretic peptide, and significant decreases in the left ventricular ejection fraction. These patients had significant increases in the duration of CCU stay and in-hospital stay, had significant increase in the rate of MACEs, had significant decreases in the survival rate during follow-up.

摘要

本研究调查了住院期间和 1 年随访期间合并高血压和高同型半胱氨酸血症(HHcy)的急性心肌梗死(AMI)患者的结局和主要不良心血管事件(MACE)。将 648 例连续 AMI 患者分为四组:(1)高血压伴 Hcy≥15µmol/L;(2)高血压伴 Hcy<15µmol/L;(3)无高血压伴 Hcy≥15µmol/L;(4)无高血压伴 Hcy<15µmol/L。这些病历中的信息包括性别、既往病史、生命体征、实验室检查、心电图、冠状动脉造影、心脏超声和药物治疗。主要终点是 CCU 住院时间、住院时间和随访期间的 MACE。我们的数据表明,高血压和 HHcy 在 AMI 患者中具有协同作用,合并高血压和 HHcy 的 AMI 患者有更严重的多支冠状动脉疾病和更频繁的非罪犯冠状动脉病变完全堵塞,脑利钠肽前体的患病率更高,左心室射血分数显著降低。这些患者 CCU 住院时间和住院时间显著延长,MACE 发生率显著增加,随访期间生存率显著降低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e847/8617252/36d9466088c9/41598_2021_2340_Fig1_HTML.jpg

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