Analysis Of Risk Factors In Patients With Coronary Heart Disease Complicated With Chronic Renal Insufficiency And Observation Of Adverse Cardiovascular Events During Hospitalization

Objective To investigate the risk factors associated with acute myocardial infarction in patients with coronary atherosclerotic heart disease and chronic renal failure and to investigate the relationship between STEMI and NSTEMI during hospitalization for adverse cardiovascular events.Methods A total of 700 cases of coronary atherosclerotic heart disease with chronic renal insufficiency patients were enrolled,including 350 cases of CKD with AMI and 350 cases of CKD without AMI patients;To collect patient-related clinical data and laboratory results and perform statistical analysis;350 cases of CKD patients with AMI were divided into two subgroups according to AMI type STEMI and NSTEMI.Relevant clinical data and laboratory results parameters were collected.The incidence of cardiovascular adverse events in two subgroups during hospitalization was also observed.Results:1.Compared with clinical data and laboratory results between CKD+AMI group and CKD group:which include the gender,history of hypertension,hemoglobin,albumin,LDL-c,HDL-c,TG,TC,hs-CRP,Scr,(P>0.05).2.The average age of patients with CKD+AMI group(77± 11.0 years)was significantly higher than those with CKD group's(75± 12.6 years)(P<0.05).The history of diabetes mellitus in CKD+AMI group(107 cases)was significantly higher than that in CKD group's(75 cases)(P<0.05).The average platelet level in CKD+AMI group(217.6±81.5×109·L-1)was significantly higher than that in CKD group's(205.0±73.O×109·L-1)(P<0.05).The mean level of cTnI in CKD + AMI group(7.4 ±2.9 ng ·mL-1)was significantly higher than that in CKD group's(0.8±0.1 ng·mL-1).The mean level of BUN(14.7±9.4 mmol·mL-1)in CKD+AMI group was significantly higher than that in CKD group's(13.1 ±7.6 mmol·mL-1)(P<0.05).3.The average level of eGFR in the CKD+AMI group(36.9±24.1%)was lower than that in the CKD group's(40.9±28.2%)(P<0.05).4.CKD+AMI as a dependent variable,gender,age,smoking history,history of hypertension,history of diabetes,platelet,hemoglobin levels,albumin,LDL-c,HDL-c,TG,TC,Scr,BUN,UA,cTnI,eGFR is an independent variable and two-class Logistic regression analysis,The results showed that age,cTnI,and eGFR were closely related to the onset of CKD with AMI patients,and the correlation coefficients B were 3.905,2.421,1.006,respectively(P<0.05).5.Compared with clinical data and laboratory results between the STEMI group and the NSTEMI group:There was no significant difference between the two groups in age,gender,smoking history,diabetes history,platelet,albumin,LDL-c,HDL-c,TG,TC,Scr,BUN,UA,eGFR(P>0.05).6.The number of PCI in STEMI group(120 cases)was significantly higher than that in NSTEMI group's(101 cases)(P<0.05);The level of Hb in STEMI group(119.3±26.1 g·L-1)was higher than that in NSTEMI group's(111.5±25.3 g·L-1)(P<0.05);the level of hs-CRP(9.8±7.8 mg·L-1)in STEMI group was significantly higher than that in NSTEMI group's(5.3±5.2 mg·L-1)(P<0.05);The level of cTnI(11.5±6.6 ng·mL-1)in the STEMI group was significantly higher than that in the NSTEMI group's(7.8±2.9 ng·mL-1)(P<0.05);There was a statistically significant difference in STEMI group with hypertension(105 cases)compared with NSTEMI group's(150 cases)(P<0.05).7.The comparison of adverse cardiovascular events during hospitalization in patients with STEMI group and NSTEMI group:There was no statistical difference between bleeding and death in adverse cardiovascular events during hospitalization between the two groups(P>0.05).8.There was a statistically significant difference in revascularization in STEMI group(125 cases)than in NSTEMI group's(106)(P<0.05).Acute heart failure in STEMI group(25 cases)was significantly higher than that in NSTEMI group's(14 cases)(P<0.05).conclusion:1.There was a significant difference in age,cTnI,and eGFR between the CKD+AMI group and the CKD group,it is suggested that age,cTnI,and eGFR may be associated with CKD and AMIL Logistic regression analysis showed that this correlation was not affected by other factors.It is suggested that age,cTnI and eGFR may be risk factors for CKD patients with AMI.2.In the CKD+AMI group and subgroups(STEMI group and NSTEMI group),with the increase of renal function,the number of AMI patients gradually decreased,and the proportion of NSTEMI group was higher than that of STEMI group's3.The number of PCI,cTnI and hs-CRP in STEMI group were higher than those in NSTEMI group's.The prevalence of hypertension in NSTEMI group was higher than that in STEMI group's.The mean hemoglobin level in STEMI group was lower than STEMI group's.4.In the adverse cardiovascular events during hospitalization in the STEMI and NSTEMI groups,The incidence of revascularization and acute heart failure in the STEMI group was higher than that in the STEMI group's,but there was no statistical difference between bleeding and adverse cardiovascular events.