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心电图无明显异常的急性冠状动脉综合征中非ST段抬高型心肌梗死的患病率:白沙瓦医学教学机构拉迪夫人医院的横断面研究

Prevalence of Non-ST-Segment Elevation Myocardial Infarction in Acute Coronary Syndrome With Unremarkable Electrocardiogram: A Cross-Sectional Study From Lady Reading Hospital, Medical Teaching Institute, Peshawar.

作者信息

Zeb Usman, Khan Nisar Ahmad, Ullah Najeeb, Khan Muhammad Hamza

机构信息

Internal Medicine, Lady Reading Hospital, Medical Teaching Institute, Peshawar, PAK.

General Surgery, Lady Reading Hospital, Medical Teaching Institute, Peshawar, PAK.

出版信息

Cureus. 2024 Sep 30;16(9):e70575. doi: 10.7759/cureus.70575. eCollection 2024 Sep.

Abstract

Introduction Patients admitted to the cardiac care unit with non-ST-segment elevation myocardial infarction frequently have inconclusive electrocardiogram results. In individuals presenting with sudden central chest discomfort, non-ST-segment elevation myocardial infarction should be suspected until confirmed or ruled out by a cardiac biomarker analysis. This study aims to determine the prevalence of non-ST-elevation myocardial infarction among acute coronary syndrome patients who present with normal electrocardiogram findings. Materials and methods This study was conducted from October 24, 2022, to April 24, 2023, and involved 120 patients who came to the cardiac emergency department at Lady Reading Hospital, Peshawar. These patients experienced chest pain and symptoms of acute coronary syndrome, all within 24 hours of the onset of their symptoms. Demographic data and clinical histories were recorded for each patient. Electrocardiograms were performed, and non-ST-segment elevation was observed. The diagnosis of non-ST-segment elevation myocardial infarction was confirmed by measuring cardiac troponin T levels. A threshold value greater than 0.5 ng/mL was considered diagnostic. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS) (IBM SPSS Statistics for Windows, Version 23, Armonk, NY), and grammar was checked using the Grammarly software (Grammarly, Inc., San Francisco, CA). Results The study participants had an average age of 53.96 years, with a standard deviation of 8.57. Most participants were male, comprising 65.83% of the total population, while 34.17% were female. Among the participants, 26.66% were diagnosed with non-ST-segment elevation myocardial infarction, affecting 32 individuals. The results showed a significant correlation between the occurrence of non-ST-segment elevation myocardial infarction and male gender, as well as with individuals who had pre-existing comorbidities. The p-values for these associations were 0.032 and 0.043, respectively, indicating statistically significant relationships. Conclusion In conclusion, a significant proportion of patients who presented to the emergency department with acute coronary syndrome symptoms and a normal electrocardiogram were diagnosed with non-ST-segment elevation myocardial infarction. This highlights the need for special attention to male patients and those with comorbidities.

摘要

引言

入住心脏监护病房的非ST段抬高型心肌梗死患者,其心电图结果常常不明确。对于突发中央胸部不适的个体,在通过心脏生物标志物分析确诊或排除之前,应怀疑为非ST段抬高型心肌梗死。本研究旨在确定心电图表现正常的急性冠状动脉综合征患者中非ST段抬高型心肌梗死的患病率。

材料与方法

本研究于2022年10月24日至2023年4月24日进行,纳入了120名前往白沙瓦瑞德夫人医院心脏急诊科就诊的患者。这些患者在症状发作24小时内均出现胸痛及急性冠状动脉综合征症状。记录了每位患者的人口统计学数据和临床病史。进行了心电图检查,观察到非ST段抬高。通过测量心肌肌钙蛋白T水平确诊非ST段抬高型心肌梗死。阈值大于0.5 ng/mL被视为诊断标准。使用社会科学统计软件包(SPSS)(IBM SPSS Statistics for Windows,版本23,纽约州阿蒙克)进行数据分析,并使用Grammarly软件(Grammarly公司,加利福尼亚州旧金山)检查语法。

结果

研究参与者的平均年龄为53.96岁,标准差为8.57。大多数参与者为男性,占总人口的65.83%,女性占34.17%。在参与者中,26.66%被诊断为非ST段抬高型心肌梗死,共32人。结果显示,非ST段抬高型心肌梗死的发生与男性性别以及有既往合并症的个体之间存在显著相关性。这些关联的p值分别为0.032和0.043,表明具有统计学意义。

结论

总之,相当一部分因急性冠状动脉综合征症状就诊且心电图正常的患者被诊断为非ST段抬高型心肌梗死。这突出了对男性患者和合并症患者给予特别关注的必要性。

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