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与 ST 段抬高型心肌梗死并发症相关的因素:单中心经验。

Factors associated with complications in ST-elevation myocardial infarction: a single-center experience.

机构信息

Unit of cardiology, University of Kinshasa, 58, Avenue Biangala, Righini, Commune Lemba, Kinshasa, Democratic Republic of Congo.

Cardiology Intensive Care Unit, Hôpital Sud Francilien, Paris, France.

出版信息

BMC Cardiovasc Disord. 2023 Sep 19;23(1):468. doi: 10.1186/s12872-023-03498-z.

Abstract

BACKGROUND

ST-elevation myocardial infarction (STEMI) is a major public health problem. This study aimed to determine the prevalence and identify the determinants of STEMI-related complications in the Cardiology Intensive Care Unit of the Sud Francilien Hospital Center (SFHC).

METHODS

We retrospectively analyzed the data of 315 patients with STEMI aged ≥ 18 years. Logistic regression was used to identify factors independently associated with the occurrence of complications.

RESULTS

Overall, 315 patients aged 61.7 ± 13.4 years, of whom 261 were men, had STEMI during the study period. The hospital frequency of STEMI was 12.7%. Arrhythmias and acute heart failure were the main complications. Age ≥ 75 years (adjusted odds ratio [aOR], 5.18; 95% confidence interval [CI], 3.92-8.75), hypertension (aOR, 3.38; 95% CI, 1.68-5.82), and cigarette smoking (aOR, 3.52; 95% CI, 1.69-7.33) were independent determinants of acute heart failure. Meanwhile, diabetes mellitus (aOR, 1.74; 95% CI, 1.09-3.37), history of atrial fibrillation (aOR, 2.79; 95% CI, 1.66-4.76), history of stroke or transient ischemic attack (aOR, 1.99; 95% CI, 1.31-2.89), and low high-density lipoprotein-cholesterol (HDL-C) levels (aOR, 3.70; 95% CI, 1.08-6.64) were independent determinants of arrhythmias.

CONCLUSION

STEMI is a frequent condition at SFHC and is often complicated by acute heart failure and arrhythmias. Patients aged ≥ 75 years, those with hypertension or diabetes mellitus, smokers, those with a history of atrial fibrillation or stroke, and those with low HDL-C levels require careful monitoring for the early diagnosis and management of these complications.

摘要

背景

ST 段抬高型心肌梗死(STEMI)是一个重大的公共卫生问题。本研究旨在确定心脏病重症监护病房(CCU)中 STEMI 相关并发症的发生率,并确定其决定因素。

方法

我们回顾性分析了 315 名年龄≥18 岁的 STEMI 患者的数据。使用逻辑回归来确定与并发症发生相关的独立因素。

结果

总体而言,研究期间共有 315 名年龄为 61.7±13.4 岁的患者患有 STEMI,其中 261 名男性。STEMI 的医院发生率为 12.7%。心律失常和急性心力衰竭是主要的并发症。年龄≥75 岁(调整后的优势比 [aOR],5.18;95%置信区间 [CI],3.92-8.75)、高血压(aOR,3.38;95% CI,1.68-5.82)和吸烟(aOR,3.52;95% CI,1.69-7.33)是急性心力衰竭的独立决定因素。与此同时,糖尿病(aOR,1.74;95% CI,1.09-3.37)、心房颤动史(aOR,2.79;95% CI,1.66-4.76)、中风或短暂性脑缺血发作史(aOR,1.99;95% CI,1.31-2.89)和低高密度脂蛋白胆固醇(HDL-C)水平(aOR,3.70;95% CI,1.08-6.64)是心律失常的独立决定因素。

结论

SFHC 中 STEMI 较为常见,常并发急性心力衰竭和心律失常。年龄≥75 岁、患有高血压或糖尿病、吸烟者、有房颤或中风史以及 HDL-C 水平较低的患者需要密切监测,以便早期诊断和处理这些并发症。

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