| Objective: To analysis the clinical characteristics and major drug use of patients with ST segment elevation myocardial infarction in our hospital, and the change of the incidence of adverse cardiovascular events during the period of 8 years. To explore the related factors of rising rate of acute myocardial infarction and summarize the experience and deficiency in treatment of acute myocardial infarction in our hospital. Provide a theoretical basis for the prevention and treatment of acute myocardial infarction.Methods: The year 2006 for 96 cases of patients hospitalized with acute ST segment elevation myocardial infarction in the Affiliated Hospital of Jining Medical College as the 2006 group, 2014 year 722 patients hospitalized in our hospital in patients with acute ST segment elevation myocardial infarction patients due to as 2014 group were analyzed retrospectively. Collect medical records of patients in the two groups,statistics two groups of patients with general information(gender, age, with hypertension, diabetes, lipid levels,smoking history), major in-hospital medication(including aspirin, clopidogrel,statins, ACEI/ARB/ spironolactone ratio), diagnosis and treatment(the time of onset to hospital, emergency percutaneous coronary intervention rate,and length of hospital stay), and adverse cardiovascular events occurred during hospitalization(recurrent angina and sudden deaths). The results were statistically analyzed using SPSS13.0 software. The measurement data of the normal distribution using mean±standard deviation((?)±s), compared with the Ttest,otherwise, use the rank sum test. Count data using rate, compared with Chi square test.Logistic regression analysis was performed to analyze the factors that were significant difference in the single factor analysis.P<0.05 the difference was statistically significant.Results:(1)There was no significant difference between the 2006 group and the 2014 group in the ratio of male patients(76.04% vs 73.13%,P=0.544),Age(6.146 ± 13.64 y vs 61.89 ± 11.79 y, P=0.768), with hypertension rate(51.04% vs 47.37%, P=0.498), with the rate of diabetes(15.63% vs 22.99%,P=0.102).The 2014 group was significantly increased in patients with a history of smoking(57.06% vs 40.63%, P=0.002).(2)There was no significant difference between the 2006 group and the 2014 group in the triglyceride levels(1.57 ± 0.97mmol/L vs 1.36 ± 0.92mmol/L, P=0.056), total cholesterol levels(4.41 ± 1.10mmol/L vs 4.43 ± 0.96mmol/L, P=0.876), low density lipoprotein cholesterol levels(2.63 ± 0.80mmol/L vs 2.64 ± 0.79mmol/L, P=0.874). The2014 group of high density lipoprotein cholesterol(HDL-C) levels was significantly lower than the 2006 group(1.09 ± 0.29mmol/L vs 1.23 ±0.39mmol/L, P=0.002).(3)The 2006 group and the 2014 group main medication during hospitalization: There was no statistically significant difference in Aspirin use rate(94.79% vs 96.5, P=0.393) and statin use rate(84.34% vs 87.95%, P=0.319). The 2014 group patients with clopidogrel usage(95.98% vs 83.33%, P<0.01), angiotensin converting enzyme inhibitors/angiotensin receptor blocker(ACEI/ARB)/spironolactone ratio significantly increased(86.98% vs 72.92%, P<0.01), but RAAS inhibition ratio is still not ideal(86.98%).(4)There was no significant difference between the2006 group and the 2014 group in the time of onset to hospital.The rate of emergency percutaneous coronary intervention of the 2014 group is increased than the 2006 group(40.17% vs 27.08%, P=0.013).The length of hospital stay and the rate of recurrent angina(10.53% vs 18.75%, P=0.018) and cardiac death(4.99% vs 12.5%, P=0.003)of the the 2014 group is significant improvement than 2006 group.(5)Adverse cardiovascular events related factors Logistic regression analysis showed that,clopidogrel can reduce the incidence of recurrent angina pectoris,clopidogrel and emergency PCI can reduce the incidence of cardiac death.Conclusion:(1) Smoking may be associated with increased incidence of acute myocardial infarction.(2) With the continuous improvement of the ratio of clopidogrel and emergency coronary intervention, the patients with STEMI were significantly improved in the rate of recurrent angina and cardiac death during hospitalization.(3)There was no significant improvement in the time of onset to hospital, suggesting that patients with acute myocardial infarction is still lack of awareness.The application rate of RAAS inhibitors is not ideal. |
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