| Objective:To investigate clinical characteristics,complicated diseases and therapies of the patients with acute myocardial infarction who were complicated with atrial fibrillation in the first affiliated Hospital of Shihezi University.Methods:All patients with AMI complicated with atrial fibrillation from January 1,2008 to September 30,2020 according to ICD-10 code were collected and classified into age ≤ 65 years group(middle-aged group),age < age ≤ 75 years group(elderly group)and age > 75 years group(elderly group).The clinical data of the three groups were collected,and the baseline data,past medical history,auxiliary examination,in-hospital treatment drugs,PCI and vascular lesions of the three groups were compared.Results : The clinical data of 278 patients with acute myocardial infarction complicated with atrial fibrillation were collected and included in the study.1.Basic information:The average age of the patients was 70.19 ± 11.39 years old.There were 87 cases(31.3%)in the age ≤ 65 years old group,90 cases(32.4%)in the age < 65 years old group and 101 cases(36.3%)in the age > 75 years old group.There were 209 males(72.9%)and 69 females(27.1%),128patients(46.2%)with acute ST segment elevation myocardial infarction(STEMI)and 150 patients(53.8%)with acute non ST segment elevation myocardial infarction(NSTEMI).There were 201 cases(72.3%)of new onset atrial fibrillation(noaf),42 cases(15.1%)of paroxysmal atrial fibrillation,20 cases(7.2%)of persistent atrial fibrillation and 15 cases(5.4%)of permanent atrial fibrillation.2.Characteristics of clinical data of different groups: compared with 65 years old < age ≤ 75 years old group and age > 75 years old group,platelet,high density lipoprotein and hemoglobin of age ≤ 65 years old group were higher(P < 0.05),NT pro BNP was great lower(P < 0.05);compared with 65 years old group and 65 years old < age ≤ 75 years old group,creatinine of age > 75 years old group was great higher;grace score from high to low was age ≤ 65 years old group and 6 years old group 5 years old < age ≤ 75 years old group,age > 75 years old group.Echocardiographic indexes: compared with 65 years old < age ≤ 75 years old group and age > 75 years old group,FS value was little lower than that of age ≤ 65 years old group.3.Treatment characteristics of different groups: The proportions of single drug antithrombotic therapy,combined antithrombotic therapy and triple antithrombotic therapy in 278 patients were 12.2%,81.6% and6.2% respectively;the proportions of single drug antithrombotic therapy in middle-aged group,elderly group and elderly group were 3.4%,11.1% and 20.8% respectively;the proportions of combined antithrombotic therapy in middle-aged group,elderly group and elderly group were 85.1%,81.1% and75.2% respectively The proportion of triple antithrombotic therapy was 11.4%,6.6% and 3.9% respectively.8%,54.2%,36.1%,18.1% respectively.In terms of antithrombotic therapy alone,there was significant difference among the three groups,and the proportion from high to low was the elderly group,the elderly group and the middle-aged group;in terms of dual antithrombotic therapy and triple antithrombotic therapy,there was no significant difference among the three groups.The proportion of cha2ds2 VASC ≥ 2 and has-bled ≥ 3 in the elderly group was significantly higher than that in the middle-aged group;the proportion of patients with cha2ds2 VASC ≥ 2 and has-bled ≥ 3 in the elderly group and the young group was significantly lower than that in the elderly group;the proportion of anticoagulant treatment in the elderly group and the elderly group was significantly lower than that in the middle-aged group.The proportion of PCI and stent implantation in middle-aged group and elderly group was higher than that in elderly group.The proportion of multi vessel disease in the elderly group and the elderly group was higher than that in the middle-aged group.4.In hospital mortality: There were 26 patients(9.3%)with AMI and AF during hospitalization,and the proportion of patients in the three groups from high to low was age > 75 years old group,65 < age ≤ 75 group,age ≤ 65 group;there were 63 patients(22.7%)with stroke,and the proportion of patients in the elderly group and the elderly group was significantly higher than that in the middle-aged group;there were27 patients(9.7%)with cardiogenic shock in the hospital,and the proportion was from high to low There were 20 cases(7.2%)in age > 75 group,65 < age ≤ 75 group and age ≤ 65 group.There were 2 cases(2.3%),8 cases(8.9%)and 14 cases(13.8%)in the middle-aged group,the elderly group and the elderly group respectively.The hospital mortality of the elderly group and the elderly group was significantly higher than that of the middle-aged group.Conclusion:1.The probability of AMI complicated with AF in our hospital was 4.95%,mainly in the age group > 75 years old,male was more than female,STEMI was more than NSTEMI,and new onset AF was the main type of AF.2.The age > 75 years group was significantly higher than the other two groups in renal dysfunction,dyslipidemia and cardiac dysfunction.3.The proportion of single antithrombotic therapy in the three groups from high to low was age > 75 years group,65 years < age ≤ 75 years group,age ≤ 65 years group;the proportion of anticoagulant therapy in 65 years < age ≤ 75 years group was high;There is a gap between antithrombotic strategy and guideline.4.PCI can reduce the incidence of adverse events in patients with acute myocardial infarction and atrial fibrillation. |
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