Bengbu Medical College, Fuyang People's Hospital Affiliated to Bengbu Medical College, Fuyang, China.
Fuyang People's Hospital Affiliated to Anhui Medical University, Fuyang, China.
Clin Appl Thromb Hemost. 2023 Jan-Dec;29:10760296231186811. doi: 10.1177/10760296231186811.
To describe the impact of delayed call time for chest pain in the salvage of ST-segment elevation myocardial infarction (STEMI) patients and its associated independent risk factors, and to identify risk factors associated with cumulative morbidity and mortality in STEMI patients at 4 years after percutaneous coronary intervention (PCI). Retrospective analysis of 398 patients diagnosed with STEMI and treated with emergency PCI within 24 hours of symptom onset in Fuyang People's Hospital from April 2018 to April 2021. The enrolled patients were divided into ≤60 minutes group (193 cases), and > 60 minutes group (205 cases), according to the delayed call time of patients with chest pain. Analysis of basic clinical data, rescue time, and major cardiovascular adverse events in the 2 groups. Multifactorial logistic regression analysis of independent correlates of delayed chest pain calls and Cox proportional risk regression modeling of risk factors for cumulative morbidity and mortality at 4 years after surgery. Compared to the delayed call time ≤ 60 minutes group, the > 60 minutes group had a higher proportion of females, a history of diabetes, rural remote areas, and farmer occupation ( < .05). Binary logistic regression analysis shows the history of diabetes and female as independent risk factors for delayed call time >60 minutes for chest pain. In the delayed call time ≤60 minutes group, the time from symptom onset-to-balloon (S0-to-B) and from symptom onset-to-first medical contact (SO-to-FMC) were smaller than in the delayed call time >60 minutes group ( < .05). The sum of postinfarction angina and major cardiovascular adverse events was lower in the group with delayed call time ≤60 minutes than in the group with delayed call time >60 minutes ( < .05). The Kaplan-Meier survival curve and the survival curve without the occurrence of major adverse cardiovascular events were statistically significant in both groups ( < .05). Multifactorial Cox regression analysis showed that delayed call time for chest pain >60 minutes, left main + 3 branch lesions, and cardiac function Killip ≥ III were all risk factors for cumulative morbidity and mortality at 4 years after PCI in patients with STEMI. Delayed call time for chest pain >60 minutes, left main + 3 branch lesions, and cardiac function Killip ≥ III are all risk factors for cumulative morbidity and mortality in STEMI patients at 4 years after PCI. Reducing the delayed call time for chest pain can improve the long-term prognosis of patients.
描述胸痛延迟呼叫时间对 ST 段抬高型心肌梗死(STEMI)患者救治的影响及其相关的独立危险因素,并确定经皮冠状动脉介入治疗(PCI)后 4 年 STEMI 患者累积发病率和死亡率的相关危险因素。回顾性分析 2018 年 4 月至 2021 年 4 月在富阳市人民医院就诊的 STEMI 患者 398 例,所有患者均于症状发作后 24 小时内行急诊 PCI 治疗。根据胸痛患者的延迟呼叫时间,将患者分为≤60 分钟组(193 例)和>60 分钟组(205 例)。分析两组的基本临床资料、抢救时间和主要心血管不良事件。多因素 logistic 回归分析胸痛延迟呼叫的独立相关因素,Cox 比例风险回归模型分析术后 4 年累积发病率和死亡率的危险因素。与胸痛延迟呼叫时间≤60 分钟组相比,胸痛延迟呼叫时间>60 分钟组女性、糖尿病史、农村偏远地区和农民职业的比例较高( < .05)。二元 logistic 回归分析显示,糖尿病史和女性是胸痛延迟呼叫时间>60 分钟的独立危险因素。在胸痛延迟呼叫时间≤60 分钟组,从症状发作至球囊扩张(S0 至 B)和从症状发作至首次医疗接触(SO 至 FMC)的时间均小于胸痛延迟呼叫时间>60 分钟组( < .05)。胸痛延迟呼叫时间≤60 分钟组的梗死后心绞痛和主要心血管不良事件的总和低于胸痛延迟呼叫时间>60 分钟组( < .05)。两组的 Kaplan-Meier 生存曲线和无重大不良心血管事件发生的生存曲线均有统计学意义( < .05)。多因素 Cox 回归分析显示,胸痛延迟呼叫时间>60 分钟、左主干 + 3 支病变和心功能 Killip≥III 是 STEMI 患者 PCI 术后 4 年累积发病率和死亡率的危险因素。胸痛延迟呼叫时间>60 分钟、左主干 + 3 支病变和心功能 Killip≥III 是 STEMI 患者 PCI 术后 4 年累积发病率和死亡率的危险因素。降低胸痛的延迟呼叫时间可以改善患者的长期预后。