Analysis of risk factors and clinical outcomes in patients with acute myocardial infarction and history of stroke
11.3969/j.issn.1672-5921.2014.07.001
- VernacularTitle:急性心肌梗死合并卒中病史患者危险因素及住院转归的分析
- Author:
Boyu LI
;
Qi HUA
;
Jing LI
;
Haixia HOU
- Publication Type:Journal Article
- Keywords:
Myocardial infarction;
Stroke;
Risk factors;
Prognosis
- From:
Chinese Journal of Cerebrovascular Diseases
2014;(7):337-341
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors,clinical characteristics and outcomes in patients with acute myocardial infarction and history of stroke. Methods A total of 771 patients with acute myocardial infarction diagnosed and admitted to Xuanwu Hospital,Capital Medical University from January 2005 to March 2012 were analyzed retrospectively. They were divided into either a stroke group (n=387)or a control group (n=384)according to whether they had previous ischemic stroke or not. The risk factors for cardiovascular disease,clinical characteristics of the disease,and clinical outcomes of the patients in both groups were compared through the case control analysis. The endpoint events observed were acute ischemic stroke,cerebral hemorrhage,and cause of death during hospitalization. Results (1)The median age of the patients in both stroke and control groups was 71 (37-91 )and 62 (29-90 )years respectively. The female patients in the stroke group were more than those in the control group (n=125 vs. n=91). The incidence of complicated with hypertension (72. 9%[n=282]and 47. 6%[n=183]) and type 2 diabetes mellitus (39. 0%[n=151]and 20. 8%[n=80]respectively)were high. There was significant difference between the two groups (P<0. 01). (2)The time from the onset to admission in patients of the stroke group was longer than that in patients of the control group (median 11 h vs. 4 h). The incidence of non-ST segment elevation myocardial infarction (16. 0%[n = 62 ]and 1. 8%[n = 7 ] respectively)was higher. The incidences of complicated with gastric stress ulcer (7. 0%[n =27 ]and 2. 1%[n=8]respectively),atrial fibrillation (10. 6%[n=41]and 3. 9%[n=15]respectively),and acute pulmonary edema-cardiac function Killip class≥Ⅱ(51. 9%[n =201 ]and 37. 8%[n =145 ] respectively)were more higher. The findings of coronary angiography in patients of the stroke group were that the incidence of left main coronary artery or 3 -branch lesion higher than that of the control group (52. 9%[126/238]and 32. 4%[97/299]respectively). There was significant difference (P <0. 05). (3)The incidence of new stroke in patients of the stroke group (5. 7%[n =22 ]and 1. 8%[n =7 ] respectively)and in hospital mortality (13. 7%[n=53]and 7. 6%[n=29]respectively)were higher than those of the control group. There were significant differences (P<0. 01). Conclusion The age of the patients with acute myocardial infarction with previous identified history of stroke is older. The incidence of female patients is higher than that of the non-stroke patients,and most of them have risk factors that complicated with hypertension and diabetes mellitus. These patients often have the complications with peptic ulcer disease and heart failure,and their coronary angiography often show multi-branch lesions,and they are more prone to ischemic cardio-cerebrovascular events during the hospitalization.
