| Objective:There are many kinds of methods for treatment for acute myocardial infarction(AMI), but the effects of long-term mortalityon AMI was not significant for the treatment of percutaneous coronary intervention(PCI), coronary artery bypass surgery(CABG) and thrombolysis. So the traetment of AMI should emphasize prevention, combination of prevention and treatment and relapse prevention concept.It is particularly important for exploring risk factors and correlation. Our research analysis risk factors of AMI patients after PCI procedure, coronary artery lesions and readmission,for the prevention of acute myocardial infarction, providing the reference for treatment and epidemiological studies, and getting more basis for CAD prevention and strategies. Methods:According to the inclusion and exclusion criteria, we select 461 cases of AMI patients after emergency PCI procedure from January 1, 2012 to December 31, 2012 in the cardiovascular center of the First Hospital of Jilin University. According to the questionnaire and detailed records of patients with specific status and examination, we made follow-up to December 31, 2015, recorded the condition of patients with readmission, and established a database to analyze the content of the above investigation, the proportion ratio and chi-square test of patient specific features. Results:1. Epidemiological characteristics of patients with acute myocardial infarction:In the screening of 461 patients, the average age of patients is 58.69±11.03 years old; The morbidity is the highest accounted for 59.9% in the subgroup of patients with 50-69 years old, there are 148 cases accounted for 32.1% in the subgroup of patients with 50-59 years old; and 128 cases accounted for 27.80% in the subgroup of patients with 60-69 years old. There are 330 cases of patients with male, and 131 cases of patients with female, incidence ratio between male and female is 2.51:1.2. The life habits and past history of patients with acute myocardial infarction:In the screening of 461 patients, there are 262 cases(56.8%) of patients with smoking, 86 cases(18.7%) of patients with alcohol, 4 cases(0.9%) of patients with previous myocardial infarction, 79 cases(17.1%) of patients with history of diabetes, 216 cases(46.9%) of patients with history of hypertension. In the patients with hypertension, the highest proportion is 85.9% of subgroup with systolic blood pressure greater than 160 mm Hg, 280 cases(60.7%) with systolic blood pressure greater than 180 mm Hg, 116 cases(25.2%) with systolic blood pressure between 160 to 179 mm Hg. There are 380 cases(82.4%) with diastolic blood pressure is less than 90 mm Hg, 64 cases(13.9%) with diastolic blood pressure between 90 to 109 mm Hg. Age is positively correlated to blood pressure. The subgroup with age above 40 years old show highest proportion of 80%, 35 cases accounting for 16.2% are in the 40-49 years old subgroup; 61 cases accounting for 28.2% are in the 50-59 years old subgroup, and 67 cases accounting for 31% are in the 60-69 years old subgroup; and 48 cases accounting for 22.2% are in the subgroup above 70 years old.3. Clinical examination and laboratory indicators:Among 461 cases of patients with acute myocardial infarction, there are 432 cases of patients(93.7%) with left atrial enlargement, 455 cases of patients(98.7%) with normal left ventricular end diastolic dimension; 360 cases of patients(78.1%) with abnormal regional wall motion.When admission, 195 cases accounting for 42.3% with increased fasting blood glucose; 454 cases accounting for 98.5% with increased total cholesterol value; 344 cases accounting for 74.6% with increased low-density-lipoprotein- cholesterol; 16 cases accounting for 3.5% with increased serum creatinine; 226 cases accounting for 49% with increased WBC.4.Coronary artery lesions of patients with acute myocard ial infarction:Among 461 cases of patients with acute myocardial infarction, 37 cases(8%) are coronary artery lesions in the left main coronary artery; 303 cases(65.7%) are proximal segment of left anterior descending artery and left circumflex coronary artery; 182 cases(39.5%) are the middle sgement lesion of left anterior descending artery; 51 cases(11.1%) are the distal segment lesion of left anterior descending artery; 200 cases(43.4%) are the distal segment lesion of left circumflex coronary artery; 332 cases(72%) are right coronary artery lesion; 385 cases of lesions without collateral circulation(83.5%), and 361 cases(78.3%) are right coronary dominant type, 111 cases(24.1%) of vascular lesions are single-vessel diseases, 175 cases(38%) of vascular lesions are double- vessel diseases, 175 cases(38%) of vascular lesions are three-vessel diseases.5. Follow- up after emergency PCI procedure:461 cases of acute myocardial infarction patients with emergency PCI were cured and discharged from hospital, we followed up to December 31, 2015, for 246 people, accounting for 53.36%, 215(46.63%) people were lost of follow-up. In 246 follow-up patients, 54 cases of recurrence of angina pectoris; 20 cases of pneumonia, 19 cases of heart failure; 22 cases died; 20 cases undergoing coronary angiography and stent implantation; 9 cases of recurrent myocardial infarction; 5 cases of arrhythmia; 12 cases were due to other reasons. The account of patients with re-admition are 53 cases, 11 cases of recurrent angina, 13 cases of heart failure patients and 20 cases of pneumonia patients. There were third-admition cases in 14 cases after procedure, 4 cases were admitted to hospital fourth times after procedure, 1 cases were admitted to hospital fifth times after procedure. In the 246 cases, there are 161 cases of patients with the recurrence of disease. 30 cases within 6 months after the relapse readmission, 37 patients were re-hospitalization after 7-12 months, 10 patients were during 13-18 months, 45 cases were during 19-24 months, there are 39 cases after more than 25 months of readmission. Conclusions:1.The average age of 461 patients with acute myocardial infarction was 58.69 + 11.03 years old. The main age of the patients was 50 to 69 years old. In patients with acute myocardial infarction, the gender ratio was 2.51:1, and the male patie nts were significantly more than women.2.Blood lipid abnormalities in patients with acute myocardial infarction were mainly manifested as elevation of total cholesterol and low density lipoprotein.3.In our study, the higher incidence of culprit vessel of coronary artery disease in patients with acute myocardial infarction: right coronary artery, left anterior descending artery and left circumflex.4.In our study 76% patients with acute myocardial infarctionhave multiple vessel disease, andthe number of vascular lesions was associated with age and hypertension.5.In our study, the main reason for the second admission to hospital wascardiogenic reasons, recurrent angina pectoris accounted for the highest incidence, non cardiogenic factors with the highest proportion of pneumonia. |
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