急性心肌梗死经皮冠状动脉介入术后不良心血管事件影响因素分析

目的 探讨新发急性心肌梗死（AMI）患者接受经皮冠状动脉介入治疗（PCI）的预后状况及其影响因素。方法 收集2018—2019年在某院首次接受PCI手术的AMI患者信息，随访2年至出现主要不良心血管事件（MACE）为观察终点，单因素分析后构建Cox回归模型，并用列线图模型展示。结果 ⑴共收集病例1 362例，出现MACE 250例；随访对象PCI术后30 d、6个月、1年、2年的MACE阳性率分别为4.63%、11.38%、14.54%和18.36%；⑵Cox回归发现有外周和脑血管病史（HR=0.755,95%CI:0.587～0.970,P=0.028）是AMI患者PCI术后预后的保护因素；心电图有异常性Q波表现（HR=1.322）、病变冠脉支数为两支（HR=1.911）、B型脑钠肽（B-type brain natriuretic peptide,BNP）>100 pg/μL(HR=1.481)、β2微球蛋白（Beta 2 microglobulin,β2-MG）>3.0 mg/L(HR=1.416)与葡萄糖（Glucose,GLU）>6.1 mmol/L(HR=...

Analysis of influencing factors of adverse cardiovascular events after percutaneous coronary intervention in acute myocardial infarction

Objective To investigate the prognosis of new acute myocardial infarction (AMI) patients undergoing percutaneous coronary intervention (PCI) and its influencing factors. Methods The information of AMI patients who underwent PCI for the first time in a hospital from 2018 to 2019 was collected. The observation endpoint was from two years of follow-up to the occurrence of major adverse cardiovascular events (MACE). Cox regression model was constructed after univariate analysis and displayed with nomogram model. Results ⑴ A total of 1 362 cases were collected and 250 cases had MACE. The positive rates of MACE at 30 days, 6 months, 1 year, and 2 years after PCI were 4.63%, 11.38%, 14.54%, and 18.536% respectively. ⑵ Cox regression showed that the history of peripheral and cerebrovascular disease (HR=0.755, 95% CI: 0.587-0.970, P=0.028) was a protective factor for the prognosis of AMI patients after PCI. ECG showed abnormal Q wave (HR=1.322), the number of diseased coronary arteries was two (HR=1.911), and B-type brain natriuretic peptide (BNP)>100 PG/μL (HR＝1.481), β2 microglobulin (Beta 2 microglobulin, β2-MG)>3.0 mg/l (HR=1.416) and glucose (GLU)>6.1 mmol/L (HR=1.353) were the risk factors (P<0.05). The prediction accuracy of the model was 88.72%, and the AUC value was 0.778. Conclusion The factors influencing the prognosis of PCI in patients with new AMI include peripheral and cerebrovascular history, abnormal Q wave of the electrocardiogram, number of coronary artery branches, BNP β2-MG, and GLU.