ST段抬高型心肌梗死患者2年随访后的死亡率预测因素：伊斯法罕ST段抬高型心肌梗死队列研究
Predictors of Mortality for Patients with ST-Elevation Myocardial Infraction after 2-Year Follow-Up: A ST-Elevation Myocardial Infarction Cohort in Isfahan Study.
作者信息
Jamalian Marjan, Roohafza Hamidreza, Soleimani Azam, Massoumi Gholamreza, Mirmohammadsadeghi Amirhossein, Dorostkar Neda, Yazdekhasti Safoura, Azarm Maedeh, Sadeghi Masoumeh
机构信息
Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
出版信息
Adv Biomed Res. 2022 Dec 26;11:116. doi: 10.4103/abr.abr_242_21. eCollection 2022.
BACKGROUND
Mortality of ST-elevation myocardial infarction (STEMI) patients is increasing in world. This study defines predictors of mortality in patients who have STEMI.
MATERIALS AND METHODS
This study was a part of the ST-elevated myocardial infarction cohort study in Isfahan conducted on 876 acute myocardial infarction (MI) followed for 2 years that 781 patient entered. The effect of predictors of mortality includes demographic, physiological, and clinical characterizes compared in two groups alive and died patients. MACE was defined as nonfatal MI, nonfatal stroke, and atherosclerosis cardiovascular disease-related death was recorded. Univariate and multiple logistic regression analyses were performed. All analyses performed using SPSS 20.0. < 0.05 considered statistically significant.
RESULTS
A total 781 patients, 117 (13%) that 72 (8.5%) was in-hospital died. The mean (standard deviation) age of the patients was 60.92 (12.77) years and 705 (81.3%) patients were males. Significant factors that affected mortality on analysis of demographic and physiological parameters were age ( < 0.001), sex ( = 0.004), transfusion ( = 0.010), STEMI type ( < 0.001), number epicardial territories >50% ( = 0.001), ventilation options ( < 0.001), smoker ( = 0.003), and diabetes ( = 0.026). Significant clinical factors affected mortality were ejection fraction (EF) ( < 0.001), creatinine ( < 0.001), hemoglobin ( < 0.001), low-density lipoprotein-cholesterol (LDL-C) ( = 0.019), and systolic blood pressure ( < 0.001). Multiple logistics regression model definition significant predictors for mortality were age ( < 0.001), heart rate (HR) ( = 0.007), EF (0.039), LDL-C ( = 0.002), and preangia ( = 0.022).
CONCLUSION
The set of factors can increase or decrease mortality in these patients. Significant predictors of mortality STEMI patients by 2-year follow up were age, HR, EF, LDL-C, and preangia. It seems that more articles need to be done in different parts of Iran to confirm the results.
背景
ST段抬高型心肌梗死（STEMI）患者的死亡率在全球范围内呈上升趋势。本研究旨在确定STEMI患者死亡率的预测因素。
材料与方法
本研究是伊斯法罕ST段抬高型心肌梗死队列研究的一部分，对876例急性心肌梗死（MI）患者进行了为期2年的随访，其中781例患者纳入研究。比较存活和死亡两组患者中死亡率预测因素（包括人口统计学、生理学和临床特征）的影响。主要不良心血管事件（MACE）定义为非致死性心肌梗死、非致死性卒中，并记录动脉粥样硬化性心血管疾病相关死亡。进行单因素和多因素逻辑回归分析。所有分析均使用SPSS 20.0软件进行。P<0.05被认为具有统计学意义。
结果
总共781例患者，117例（13%）死亡，其中72例（8.5%）死于住院期间。患者的平均（标准差）年龄为60.92（12.77）岁，705例（81.3%）为男性。在人口统计学和生理学参数分析中，影响死亡率的显著因素包括年龄（P<0.001）、性别（P = 0.004）、输血（P = 0.010）、STEMI类型（P<0.001）、心外膜区域受累>50%（P = 0.001）、通气方式（P<0.001）、吸烟者（P = 0.003）和糖尿病（P = 0.026）。影响死亡率的显著临床因素包括射血分数（EF）（P<0.001）、肌酐（P<0.001）、血红蛋白（P<0.001）、低密度脂蛋白胆固醇（LDL-C）（P = 0.019）和收缩压（P<0.001）。多因素逻辑回归模型确定的死亡率显著预测因素为年龄（P<0.001）、心率（HR）（P = 0.007）、EF（P = 0.039）、LDL-C（P = 0.002）和心绞痛（P = 0.022）。
结论
这些因素可增加或降低这些患者的死亡率。通过2年随访，STEMI患者死亡率的显著预测因素为年龄、HR、EF、LDL-C和心绞痛。似乎需要在伊朗不同地区开展更多研究以证实这些结果。
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