| Objective: A retrospective analysis of the use of statins in patients with acute myocardial infarction who were initially diagnosed with acute myocardial infarction and who underwent PCI was performed to investigate factors affecting non-sustained use of statins in patients and major adverse cardiovascular events（MACE）.Methods:（1）Follow-up observations of patients who underwent initial myocardial infarction in our hospital from January 2015 to December 2017 and were successfully treated with PCI were included in the follow-up range according to the selection criteria.The follow-up time was December 2018.During follow-up,patients were observed for non-continuous use of statins and to observe whether patients were re-admitted to the hospital due to MACE events.Observed indicators include: gender,age,ethnicity,education level,occupation,marriage,medical insurance,history of hypertension,history of diabetes,history of hyperlipidemia,history of smoking,family history of cardiovascular disease,acute myocardial admission Infarction Killip classification,coronary artery disease count,myocardial infarction type,PCI surgery date,first hospital stay,first discharge,first statin date,whether there is non-continuous use of statins,is it because Baseline data such as the re-admission of the MACE event and the prognosis of the patients were analyzed by SPSS 23.0,and the correlation between each variable and MACE was analyzed.Results: 1.Follow-up:As of December31,2018,a total of 201 patients were followed up,170 males,accounting for 84.6%,and 31 females,accounting for 15.6%.The age is 89 years old,the youngest is 40 years old,and the average value is 64 years old,including 96 cases in the elderly group,accounting for 47.8%,and 105 cases in the non-elderly group,accounting for 52.2%.The follow-up period was up to 56 months and the shortest 12 months,with an average of27.8 months.2.Comparison of baseline data:Basic characteristics of the two groups of patients（age,gender,ethnicity,education,occupation,marriage,medical insurance）;disease characteristics: past history(history of hypertension,history of diabetes,history of hyperlipidemia,history of smoking,presence There was no significant difference in the family history of cardiovascular disease,（Killip grade,coronary artery disease count,myocardial infarction type）,length of hospital stay,and follow-up time.3.Factors affecting discontinuation use of statins: 57 patients in the ndiscontinuation drug group,144 patients in the continuous drug group,and the non-sustained drug use rate was 19%.The gender and educational level of the non-sustained drug group and the continuous drug group were statistically significant.Cox multivariate analysis is consistent with univariate analysis4.Factors affecting MACE: 75 cases occurred in the MACE group,126 cases did not occur in the MACE group,and the overall MACE rate was 25%.There were 46 cases of MACE in the non-continuous medication group,and the incidence of MACE was 15%.Univariate results showed that age,gender,Killip grade,non-continuous use of statins were statistically significant,with independent effects on MACE;survival curves were plotted using Kaplan-Meier method,log-rank test,and non-continuous use of statins The drug and gender survival curves were statistically significant.After controlling for confounding factors,Cox regression showed that Killip graded,non-continuous use of statins was associated with MACE.Conclusion:（1）.Discontinuation use of statins is an independent factor in the development of MACE,and discontinuation use of statins increases the incidence of MACE.（2）.For patients who need long-term statin therapy,there is still plenty of room to optimize statin compliance.Patients with no serious side effects or contraindications to the use of statins,the vast majority of patients with indications for statin use,should adhere to lifelong continuous use of statins to improve their long-term prognosis. |
PDF Full Text Request