| Purpose:This study was designed to analyze the incidence and risk factors of clinical events after percutaneous coronary intervention in patients with coronary atherosclerotic heart disease(CHD)and non-valvular atrial fibrillation(AF),which might improve the life quality and reduce the incidence of clinical events and through the application of inflatable pulse analyzer with wrist band to detect the pulse of patients with coronary heart disease complicated with atrial fibrillation,explore the analysis method of pulse diagram of patients with coronary heart disease and atrial fibrillation,as well as the distribution of different TCM syndromes and the characteristics of pulse diagram,which can provide data support for TCM syndrome differentiation and pulse detection of patients with coronary heart disease and atrial fibrillation.Material and method:(Paper 1)This is a single-center retrospective study,which included a total of 28,933 patients who admitted to the Department of Cardiology of the General Hospital of Northern Theater Command from January 1,2013 to January 31,2016 with the initial diagnosis of coronary heart disease.The patients were screened according to the inclusion and exclusion criteria,and were divided into two groups by with or without AF(referred to as AF group and Non-AF group).The AF group and the Non-AF group were matched according to the ratio of 1:3 under the method of propensity score matching.Finally,406 patients in the AF group and 1218 patients in the Non-AF group were selected for analysis.(Paper 2)Under the guidance of the theoretical basis of pulse diagnosis in traditional Chinese medicine,we followed-up of the patients with persistent AF in paper one and explained research objectives and methods to these patients,analysis of TCM syndromes and syndromes of patients who volunteered to participate in pulse analyzer,and apply LGX-2016 H wristbands inflatable pulse condition instrument is used to detect the pulse condition in patients with coronary heart disease,atrial fibrillation,using SPSS statistical software to analyze the parameters of the pulse condition in figure 22.0,it is concluded that patients with coronary heart disease with atrial fibrillation figure characteristics of TCM syndrome type distribution and pulse condition.Results:(Paper 1)Analysis of Incidence and Risk Factors of Clinical Related Events in Patients with Coronary Heart Disease Complicated with Non-valvular Atrial Fibrillation after Percutaneous Coronary Intervention 1.There was no significant difference in the incidence of medication and clinical events between the AF group and the non-AF group during the period of hospitalization(P>0.05).The incidence of clinical events during the follow-up period was much higher in the AF group than that in the non-AF group,and the mortality and ischemic events occurred were also higher in the AF group(P<0.05).2.After analysis of clinical events such as myocardial infarction,ischemic stroke,total MACCE events during follow-up,ischemic events during follow-up,all-cause death,NYHA Ⅲ-level,left ventricular ejection fraction(LVEF),creatinine clearance(Ccr),gender,Ⅳsmoking,and triglyceride levels were the risk factors for various events.3.The main risk factors for MACCE events during follow-up included AF group,gender,NYHA Ⅲ-Ⅳ,Ccr,LVEF,CHA2DS2-VASc score and bleeding risk factors;4.The main risk factors of myocardial infarction during follow-up included HAS-BLED score,smoking,bleeding risk factors,LVEF;5.Risk factors for ischemic stroke included the history of stroke,Ccr,TG;6.Risk factors for ischemic events during follow-up included the AFgroup,sex,CHA2DS2-VASc score,NHYA grade Ⅲ-Ⅳ,Ccr,TC,LVEF;7.Risk factors for all-cause mortality during follow-up included gender,NHYA Ⅲ-levelⅣ,Ccr,LVEF,CHA2DS2-VASc score.(Paper 2)Study on distribution of different TCM syndromes and application of pulse imaging in patients with coronary heart disease complicated with atrial fibrillation after PCI 1.The top 5 TCM syndromes of patients with coronary heart disease complicated with atrial fibrillation were blood stasis syndrome,qi deficiency syndrome,wet turbidness syndrome,Yin deficiency syndrome and qi stagnation syndrome;2.The most common syndromes are blood stasis syndrome,qi stagnation and cardiothoracic syndrome,qi yin deficiency syndrome and phlegm and turbidness obstruction syndrome;3.The pulse conditions of patients with coronary heart disease complicated with atrial fibrillation belong to the pulse promotion,knot,disease,sanmai,astrainous and cord-clearing methods in traditional Chinese medicine;4.The SBP and DBP of the patients in the pulse promoting,knot and disease group were significantly lower than those in the pulse promoting,knot and disease group.The ratio of H1(y)/h1(y)was the highest,that is,the radial artery had the worst compliance;5.The qi stagnation and cardiothoracic syndrome H1(y)and h1(y)are lower than other syndroms,the pulse to number of qi yin deficiency syndrome is the highest,the phlegm turbidity closure obstruction syndrome H1(y)/ h1(y)is the lowest,and the blood stasis obstruction syndrome has the lowest pulse rate.Conclusion:(Paper 1)Analysis of Incidence and Related Factors of Clinical Related Events in Patients with Coronary Heart Disease Complicated with Non-valvular Atrial Fibrillation after Percutaneous Coronary Intervention 1.Atrial fibrillation is the main risk factor for ischemic event and MACCE during follow-up;2.Males,NYHA Ⅲ-Ⅳ,low LVEF,low Ccr and high CHA2DS2-VASc score are the main risk factors of much of the events;3.The incidence of clinical events after PCI in patients with coronary heart disease and atrial fibrillation was higher than that in patients without atrial fibrillation,which was associated with a poor clinical prognosis and high mortality.(Paper 2)Study on distribution of different TCM syndromes and application of pulse imaging in patients with coronary heart disease complicated with atrial fibrillation after PCI 1.Frequency of TCM syndromes in patients with atrial fibrillation of coronary heart disease: blood stasis > qi deficiency > wet turbidity > yin deficiency > phlegm and turbidity > qi stagnation,TCM syndromes incidence were: blood stasis syndrome > qi stagnation and cardiothoracic syndrome > qi-yin deficiency syndrome > phlegm and turbid blocking syndrome;2.LGX-2016 H wrist band inflating traditional Chinese medicine pulse imaging device can be used to detect the pulse of patients with coronary heart disease atrial fibrillation,pulse rhythm,pulse rate,pulse position(that is disease position)depth can be determined by the pulse diagram,and can judge promoting pulse,knot pulse,fast pulse,loose pulse,astragenous pulse and untwining rope pulse,which is helpful to guide the diagnosis and treatment of clinical diseases. |
PDF Full Text Request