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多支血管病变的急性心肌梗死患者的临床特征和短期预后 - 单一中东三级医疗中心的经验。

Clinical Characteristics and Short-Term Outcomes of Patients Presenting with Acute Myocardial Infarction having Multi-vessel disease - A Single Middle- eastern Tertiary-Care Center Experience.

机构信息

Banha University, Banha, Egypt; King Abdullah Mediacl City, Makkah, Saudi Arabia.

King Abdullah Mediacl City, Makkah, Saudi Arabia.

出版信息

Indian Heart J. 2022 Jan-Feb;74(1):28-33. doi: 10.1016/j.ihj.2021.11.184. Epub 2021 Dec 2.

Abstract

OBJECTIVE

Patients with multi-vessel coronary artery disease (MVD) compared to single-vessel coronary artery disease (CAD) have more comorbidities and poor in-hospital outcomes. We aim to analyze MVD-AMI patients regarding clinical data and short-term outcomes.

METHODS

This is a retrospective analysis of the prospectively collected data registry, a single-center study reviewing the clinical details and hospital outcome measures of AMI patients referred to our center for early revascularization from 2016 to 2019.

RESULT

Out of 3041 patients presented with AMI, 491 (16%) had MVD on coronary angiogram. MVD-AMI patients were older, had a higher prevalence of DM, HTN, and prior history of ischemic heart disease compared to the non- MVD -AMI group (p < 0.001 for all). However, they presented more with non-anterior myocardial infarction, showed higher rates of post-myocardial infarction LV dysfunction, and mortality (p < 0.001). Older MVD-AMI patients showed higher rates of in-hospital morbidities and mortality compared to younger ones (p < 0.001). MVD- AMI women and Middle Eastern patients were older and showed a higher prevalence of cardiovascular risk factors compared to MVD-AMI men and South Asian patient population respectively. There were no significant differences recorded among the different subgroups of MVD-AMI patients regarding the hospital outcome measures.

CONCLUSION

Our study highlighted the clinical characters and poor outcomes of a high-risk group of MVD-AMI with different demographic backgrounds. Although age was a strong predictor for in-hospital poor outcomes, neither gender nor ethnicity affected the outcomes in them.

摘要

目的

与单支血管病变性冠心病(CAD)患者相比,多支血管病变性冠心病(MVD)患者合并症更多,住院预后更差。本研究旨在分析多支血管病变性急性心肌梗死(AMI)患者的临床数据和短期预后。

方法

这是一项回顾性分析,对 2016 年至 2019 年期间,因早期血运重建而被转诊至我院的 AMI 患者的前瞻性收集数据进行了回顾性分析,旨在分析多支血管病变性 AMI 患者的临床数据和短期预后。

结果

在 3041 例 AMI 患者中,491 例(16%)冠状动脉造影显示多支血管病变。与非多支血管病变性 AMI 患者相比,多支血管病变性 AMI 患者年龄更大,患有糖尿病、高血压和缺血性心脏病的比例更高(所有比较均 p<0.001)。然而,他们更多地表现为非前壁心肌梗死,心肌梗死后左心室功能障碍和死亡率更高(所有比较均 p<0.001)。与年轻患者相比,老年多支血管病变性 AMI 患者的住院并发症和死亡率更高(p<0.001)。多支血管病变性 AMI 女性和中东患者的年龄更大,且与多支血管病变性 AMI 男性和南亚患者相比,心血管危险因素的发生率更高。不同亚组的多支血管病变性 AMI 患者在住院预后指标方面无显著差异。

结论

本研究强调了具有不同人口统计学背景的高危多支血管病变性 AMI 患者的临床特征和不良预后。尽管年龄是住院不良预后的强有力预测因素,但性别和种族对其预后无影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bca/8891000/f89fdcf7a81a/gr1.jpg

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