Piwpong Ratchanee, Plienthaisong Bulan, Plongram Thunsuda, Ngaosri Wilaiwan, Narasri Thachaiya
Faculty of Nursing, Buriram Rajabhat University, Thailand.
Department of Critical Care Nursing, Buriram Hospital, Buriram Province, Thailand.
Belitung Nurs J. 2025 Apr 19;11(2):232-239. doi: 10.33546/bnj.3672. eCollection 2025.
Acute coronary syndrome (ACS) is a severe cardiovascular condition that can lead to acute myocardial infarction (AMI), resulting in significant morbidity and elevated mortality rates.
This study aimed to examine complications arising from ACS in patients admitted to a tertiary hospital and identify the influencing factors.
A cross-sectional study was conducted between February and December 2021 among patients diagnosed with ACS at the tertiary hospital in Northeastern Thailand. The sample included 133 participants hospitalized for ACS. Simple random sampling was employed, with data collected from the patient registry by selecting 15 individuals at a time until the target of 1,998 patients was reached. Statistical analyses included descriptive statistics, Chi-Square test, Fisher's exact test, and binary logistic regression to identify significant predictors of complications in this population.
Factors influencing the occurrence of major adverse cardiac events (MACE) included cardiac function and the need for cardiopulmonary resuscitation (CPR). Patients with New York Heart Association (NYHA) class II-IV had a significantly higher risk of MACE compared to those with NYHA class I ( <0.001; 95% CI, 2.008-10.984). Additionally, patients who received CPR were 4.15 times more likely to experience MACE than those who did not receive CPR ( <0.05; 95% CI, 1.029-16.729).
This study demonstrated that cardiac function and the necessity for CPR significantly influence the development of MACE in patients with ACS. These findings highlight the importance of thorough evaluation and monitoring by healthcare teams during hospitalization, particularly for patients with abnormal cardiac function or a history of CPR. Prompt identification and targeted interventions for high-risk individuals can improve outcomes and reduce complications. Nurses should prioritize follow-up evaluations for ACS patients with NYHA class II-IV or those who have undergone CPR, as these individuals are at elevated risk for developing MACE.
急性冠状动脉综合征（ACS）是一种严重的心血管疾病，可导致急性心肌梗死（AMI），从而造成显著的发病率和死亡率上升。
本研究旨在调查一家三级医院收治的ACS患者出现的并发症，并确定影响因素。
2021年2月至12月期间，在泰国东北部的三级医院对诊断为ACS的患者进行了一项横断面研究。样本包括133名因ACS住院的参与者。采用简单随机抽样，每次从患者登记册中选取15名个体收集数据，直至达到1998名患者的目标。统计分析包括描述性统计、卡方检验、费舍尔精确检验和二元逻辑回归，以确定该人群中并发症的显著预测因素。
影响主要不良心脏事件（MACE）发生的因素包括心功能和心肺复苏（CPR）的需求。纽约心脏协会（NYHA）II-IV级患者发生MACE的风险显著高于NYHA I级患者（<0.001；95%CI，2.008-10.984）。此外，接受CPR的患者发生MACE的可能性是未接受CPR患者的4.15倍（<0.05；95%CI，1.029-16.729）。
本研究表明，心功能和CPR的必要性显著影响ACS患者MACE的发生。这些发现凸显了医疗团队在住院期间进行全面评估和监测的重要性，特别是对于心功能异常或有CPR病史的患者。对高危个体进行及时识别和有针对性的干预可以改善预后并减少并发症。护士应优先对NYHA II-IV级的ACS患者或接受过CPR的患者进行随访评估，因为这些个体发生MACE的风险较高。
