Analysis of the risk factors of patients with acute coronary syndrome sufferin hemorrhage during hospitalization
10.3760/cma.j.issn.0253-3758.2012.11.002
- VernacularTitle:急性冠状动脉综合征患者住院期间发生出血的临床危险因素评估
- Author:
Xin LIU
1
;
Yun-Dai CHEN
;
Shu-Zheng L(U)
;
Ze-Ning JIN
;
Hong LIU
;
Xian-Tao SONG
Author Information
1. 100029,首都医科大学附属北京安贞医院心内科
- Keywords:
Coronary disease;
Hemorrhage;
Risk factors
- From:
Chinese Journal of Cardiology
2012;40(11):902-907
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the risk factors related to in-hospital bleeding for patients with acute coronary syndrome (ACS).Methods Clinical and therapeutic data of 3807 patients who were registered with acute coronary syndrome in SINO-GRACE in China from March 2001 to December 2007 were reviewed.A total of 57 patients were grouped to bleeding group and 234 out of the remaining 3750 patients without bleeding were randomly chosen and served as non-bleeding group.Hemorrhage-related factors were screened and compared between the two groups.Unitary logistic regression analysis was performed to detect the possible factors related to hemorrhage.Factors with P ＜ 0.1 were further analyzed by stepwise regression method and multivariate conditional logistic regression analyses.Results (1) Age,history of coronary artery bypass graft (CABG),previous hemorrhage,renal failure and heart failure as well incidence of acute coronary syndrome were significantly higher in bleeding group than in non-bleeding group (all P ≤0.05).Patients were more often treated with clopidogrel and glycoprotein (GP) Ⅱ b/Ⅲ a receptor antagonist in bleeding group than in non-bleeding group.(2) Single factor logistic regression analysis showed that age ＞70 years,history of previous bleeding,renal failure,heart failure,clopidogrel and GP Ⅱ b/Ⅲ a receptor antagonists use,non-ST-segment elevation myocardial infarction,inferior wall,lateral myocardial infarction,CABG were risk factors for bleeding (all P ＜ 0.05).(3) Multivariate logistic regression analysis showed that history of renal failure (OR =19.77,95％ CI 4.38-89.18,P ＜ 0.01) and clopidogrel (OR =19.77,95％ CI 4.38-89.18,P ＜ 0.01) and GP Ⅱ b/Ⅲ a receptor antagonist (OR =343.57,95％ CI 40.39-999.99,P ＜ 0.01) use were the independent risk factors for bleeding.Conclusion Our results show that renal failure history and clopidogrel and GP Ⅱ b/Ⅲ a receptor antagonist use are independent risk factors for in-hospital bleeding in patients with acute coronary syndrome.
