ABSTRACT
Objective: To investigate the correlation between admission blood glucose (ABG) level and long-term prognosis in patients with acute coronary syndrome (ACS) without diabetes mellitus (DM). Methods: A total of 585 ACS patients received percutaneous coronary intervention (PCI) in our hospital from 2014-01 to 2015-10 were consecutively enrolled and no one combined with DM. Based on ABG levels, the patients were divided into 2 groups:ABG≥7.0 mmol/L group,n=133 and ABG0.05. Compared with ABG<7.0 mmol/L group, the patients in ABG≥7.0 mmol/L group had the higher incidences of MACE, PCI complication, recurrence of angina and more re-admissions for cardiac event, all P<0.05.Cox regression mode lanalysis in dicated that in addition to acute STEMI (HR=2.016), malignant arrhythmia (HR=3.028) and previous MI history (HR=2.293), blood glucose≥7.0mmol/L was also an independent risk factor for poor long-term prognosis in relevant patients. Conclusion: ABG≥7.0 mmol/L implies poor long-term prognosis in ACS patients and special attention is necessary in secondary prevention.
ABSTRACT
<p><b>OBJECTIVE</b>To set up the multiple risk factors model of patients with anatomical left ventricular aneurysm (LVA) post acute ST-elevation myocardial infarction (STEMI) and quantitatively assess the pathopoiesis of all the factors.</p><p><b>METHODS</b>A total of 518 consecutive inpatients with acute STEMI hospitalized from June 2010 to December 2013 in our hospital were enrolled in this study, patients were divided into two groups: LVA group (n = 106, 20.5%) and non-LVA group (n = 412, 79.5%). All demographic and clinical data were collected by cardiologists. Finally, all of the risk factors for anatomical LVA in the acute STEMI patients were quantitatively analyzed by a binary logistic regression model.</p><p><b>RESULTS</b>The multiple risk factors logistic regression model was set up for the anatomical LVA in patients with acute STEMI. Anterior wall myocardial infarction, occlusion of the left anterior descending branch, two or three vessels stenosis, high systolic blood pressure, sinus tachycardia and white blood cell count over 10 000 per microliter were all independent risk factors of the LVA in acute STEMI, with the odds ratio (OR) 18.21, 21.56, 4.22, 7.16, 1.98 and 1.57, respectively (all P < 0.05) . However, first medical contact less than 12 hours (OR = 0.60), collateral circulation of the coronary arteries(OR = 0.53), primary percutanous coronary intervention(OR = 0.23) and venous thrombolysis(OR = 0.12) were all protecting factors of the LVA in acute STEMI patients (all P < 0.05).</p><p><b>CONCLUSION</b>Anterior wall STEMI, occlusion of the left anterior descending branch, two or three vessels stenosis, high systolic blood pressure, sinus tachycardia and white blood cell count over 10 000 per microlitre are independent risk factors of the LVA in acute STEMI patients. However, first medical contact less than twelve hours, collateral circulation of the coronary arteries, together with the primary percutanous coronary intervention and venous thrombolysis are protective factors of the LVA in patients with acute STEMI. It is important for cardiologists to assess the risks of LVA and make emergent and suitable efforts to reduce the risk of developing LVA in STEMI patients.</p>