突尼斯非 ST 段抬高型急性冠状动脉综合征患者死亡的长期预测因素。
Long-term predictors of death among Tunisian patients presenting for non ST-elevation acute coronary syndrome.
出版信息
Tunis Med. 2021;99(7):744-750.
BACKGROUND
Coronary artery disease is the leading cause of death in emerging countries. Contemporary data about clinical profile and prognosis in Tunisian patients presenting for non ST-elevation acute coronary syndrome (NSTE-ACS) are lacking.
AIM
We sought to study the risk profile and 3-year mortality predictors in Tunisian patients presenting for NSTE-ACS in the contemporary setting.
METHODS
In this single center study, data about all consecutive patients presenting to our center for NSTE-ACS from April 2014 to July 2016 were extracted and outcomes exhaustively updated. 3-year mortality predictors were determined by multivariable survival analysis.
RESULTS
A total of 340 patients were included, of which 204 (61.8%) were male. Mean age was 63.6 ± 10.3 years. Prevalence of diabetes mellitus, hypertension and smoking was 57.3%, 62.4%, and 45.3%, respectively. In-hospital, 6, 12 and 36-month mortality rate was 2.3%, 3.2%, 7.1% and 15.2%, respectively. In multivariable survival analysis, independent predictors of death were age >75 (HR=5.45, 95% CI: 2.9-10.03, p<0.001), ST-segment deviation (HR=1.86, 95% CI: 1.04-3.33, p=0.036), anemia (HR=2.56, 95% CI: 1.41-4.67, p=0.002), left ventricular ejection fraction (LVEF) <40% (HR=3.5, 95% CI: 1.84-6.67, p<0.001) and a Global Registry of Acute Coronary Events (GRACE) score ≥140 (HR=2.38, 95% CI: 1.02-5.57, p=0.044).
CONCLUSION
In Tunisian patients presenting for NSTE-ACS, long-term mortality was high. Advanced age, ST-segment deviation, anemia, LVEF <40% and a GRACE score ≥140 were independent long-term predictors of death.
背景
在新兴国家，冠心病是导致死亡的主要原因。目前缺乏关于突尼斯非 ST 段抬高型急性冠状动脉综合征（NSTE-ACS）患者临床特征和预后的当代数据。
目的
我们旨在研究突尼斯 NSTE-ACS 患者的风险特征和 3 年死亡率预测因素。
方法
在这项单中心研究中，提取了 2014 年 4 月至 2016 年 7 月期间我院收治的所有连续 NSTE-ACS 患者的数据，并进行了详尽的结果更新。通过多变量生存分析确定 3 年死亡率预测因素。
结果
共纳入 340 例患者，其中 204 例（61.8%）为男性。平均年龄为 63.6±10.3 岁。糖尿病、高血压和吸烟的患病率分别为 57.3%、62.4%和 45.3%。住院期间、6 个月、12 个月和 36 个月的死亡率分别为 2.3%、3.2%、7.1%和 15.2%。多变量生存分析显示，年龄>75 岁（HR=5.45，95%CI：2.9-10.03，p<0.001）、ST 段偏移（HR=1.86，95%CI：1.04-3.33，p=0.036）、贫血（HR=2.56，95%CI：1.41-4.67，p=0.002）、左心室射血分数（LVEF）<40%（HR=3.5，95%CI：1.84-6.67，p<0.001）和全球急性冠状动脉事件登记（GRACE）评分≥140（HR=2.38，95%CI：1.02-5.57，p=0.044）是死亡的独立长期预测因素。
结论
在突尼斯 NSTE-ACS 患者中，长期死亡率较高。高龄、ST 段偏移、贫血、LVEF<40%和 GRACE 评分≥140 是死亡的独立长期预测因素。
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