Study On Acute Myocardial Infarction Patients’ Quality Of Life And Death Related Factors

Coronary heart disease (CHD) is the main killer to human health. CHD patients always have emotion disorder like anxiety or depression, which may have impact on their survival and prognosis. Collect baseline and clinical information, do some social research, analyze the most relevant factors to social support, quality of life, emotion disorder like anxiety or depression, and personality type, provide guidance to primary prevention and treatment of CHD, and improve patients’survival and prognosis. With the advance of treatment, the mortality of CHD is declining, Do logistic regression analysis to the factors about death, then combine with clinical practice, which can be useful to judge the CHD patients with high risk, so make it possible for further reducing mortality, improving quality of life and prognosis of patients. CHD is the most cause of sudden cardiac death (SCD), it often shows like any type of arrhythmias, so analyzing the before-death ECG or the type of arrhythmias of CHD patients can help understanding and identification of patients with high risk of SCD before some irreversible event happening. Base on the biology-psychology-society medicine model, during the primary prevention and treatment of CHD, considering all, focusing on relevant factors, will do good to the survival and prognosis of CHD patients.Part One OBJECTIVES:Aiming to discuss the impact of CHD acute myocardial infarction (AMI) patients’ baseline and clinical information on social support, quality of life, emotion disorder like anxiety or depression, and personality type, and analyze the correlation. METHODS:collect the information of AMI patients, do social research by scoring scales, compare every factor stratified, and analyze the correlation. RESULTS: Age, sex, profession, residence, education, AST, CKMB, lung infection and pleural effusion have significant impact on social support. Age, sex, profession, education, the site of myocardial infarction, the history of CHD, Cr, FBS, arrhythmias and lung infection have significant impact on quality of life. Profession, education, the site of myocardial infarction, the history of stroke, FBS, BNP, the size of heart and arrhythmias have significant impact on anxiety status. Sex, profession, education, the site of myocardial infarction, the history of stroke, BNP and arrhythmias have significant impact on depression status. There is positive correlation between social support and quality of life score, and there is strong positive correlation between anxiety and depression score. There exists significant difference among every type of personality. CONCLUSION:Lacking of social support, declining of quality of life, different personality type and emotion disorder like anxiety or depression all can influence the occurrence, development and prognosis of CHD. We must base on the biology-psychology-society medicine model, integrated control various factor, improve the survival and prognosis of CHD patients.Part Two OBJECTIVES:Aiming to discuss the predicting risk factors of death for cardiac rupture of AMI patients. METHODS:Collect the baseline and clinical information of AMI patients, group them into survival and death, do single-factor and multi-factors binary logistic regression and combine with clinical practice, then confirm the predicting factors to cardiac rupture. RESULTS:old age, female, STEMI, elevation of myocardial enzymes, elevation of AST, abnormal heart rate and history of stroke are high risk of cardiac rupture after AMI; history of CHD can lower the cardiac rupture risk. CONCLUSIONS:Focusing on the patients with high risk factors during the treatment of AMI will help reducing the incidence of cardiac rupture and improving the survival and prognosis.Part Three OBJECTIVES:Aiming to analyze the main types of arrhythmias of patients with SCD after AMI. METHODS:Collect the AMI patients’before-death ECG information, analyze the direct cause of death and give classification of death, then discuss the main types and mechanism of before-death arrhythmias of SCD patients. RESULTS:More than half of deaths after AMI are classified into SCD, the primary cause is rapid ventricular arrhythmias (60.61%), the second cause is cardiac rupture (30.30%); Brady-arrhythmia (9.09%) is found only in non-sudden cardiac death (NSCD). CONCLUTIONS:Using implantable cardioverter defibrillator (ICD) or radiofrequency catheter ablation (RFCA) to prevent malignant arrhythmias will reduce the incidence of SCD after AMI effectively.