Analysis of risk factors for death in patients with acute myocardial infarction / 中国综合临床

ABSTRACT

Objective To explore the risk factors related to death in patients with acute myocardial infarction(AMI) in hospital,so as to guide clinical treatment to reduce the occurrence of death.Methods Two hundred and seventy cases with AMI who got in infarction within 24 h were studied in the Cardiology Departmentof Zhongnan Hospital of Wuhan University from Jan.2010 and Jun.2013.The patients were divided into the death group(n =32) and the cured group(n =232) according to the endpoint in hospital.The clinical information was recorded and multiple factors logistic regression analysis was applied to analyze the risk factors of death due to AMI.Results The age,serum creatinine(Cr) in both groups were ((65.21 ± 13.55) years old,(76.41 ±10.19) years old) and ((100.23 ±65.99) μmol/L,(139.22 ±92.03) μmol/L) and there were statistically significant differences (P ＜ 0.05).The differences of other indicators in two groups were no statistically significant.Clinical data comparison between the two groups showed that incidence rate of arrhythmia (14.7％),the disease rate of anterior descending coronary artery (50.4％),the disease rate of circumflex branch coronary artery (48.7％),the level of high sensitivity C reactionprotein (hs-CRP) ((5.92 ± 4.41) mg/L),brain natriuretic peptide (BNP) ((844.89 ± 1108.41) ng/L) and creatine kinase-MB (CK-MB) ((87.99 ± 140.45)U/L) in death group were lower than those in cured group (31.3％,81.3％,68.8％,(10.82 ± 2.29) mg/L,(1210.57 ± 984.44) ng/L,(161.86 ± 214.75) U/L; P ＜ 0.05).Multiple factors logistic regression analysis showed that elder age (OR =1.078,95 ％ CI1.014-1.118,P =0.015),arrhythmia occurred or not in hospital (OR =1.636,95％ CI1.151-3.041,P =0.024),the pathological changes of anterior descending coronary artery (OR =1.428,95 ％ CI1.143-2.437,P =0.018),the level of hs-CRP (OR =1.352,95％ CI1.137-1.607,P =0.001) were the independent risk factors for myocardial infarction patients' death.Conclusion Elder age,arrhythmia occurred in hospital,the pathological changes of anterior descending coronary artery,the high level of hs-CRP are the independent risk factors for AMI patients death.Relevant measures in the treatment should be taken to reduce their risk of death.