Risk factors of short term mortality in patients with acute ST-elevation myocardial infarction complicated with fatal arrhythmia
10.3760/cma.j.issn.0253-3758.2013.07.008
- VernacularTitle:急性心肌梗死合并致死性心律失常的近期死亡危险因素分析
- Author:
Juan WANG
1
;
Yan-Min YANG
;
Jun ZHU
;
Hui-Qiong TAN
;
Li-Sheng LIU
Author Information
1. 100037,北京协和医学院 中国医学科学院阜外心血管病医院心内科急重症中心
- Keywords:
Myocardial infarction;
Arrhythmia;
Mortality;
Prognosis
- From:
Chinese Journal of Cardiology
2013;41(7):549-558
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the independent risk factors associated with short term mortality in patients with ST-segment elevation acute myocardial infarction (STEMI)complicated with fatal arrhythmia.Methods We analyzed data from Chinese STEMI patients with fatal arrhythmia enrolled in the CREATE trial.Predictors of 30-day mortality after STEMI were identified by univariate and multivariate logistic regression analysis using baseline and therapy variables.Results The overall 30-day mortality of STEMI patients complicated with fatal arrhythmia among the 718 patients [(66.1 ± 11.9) years and 62.4％ male] was 52.9％.Logistic regression analysis showed that age (OR =1.82,95％ CI:1.449-2.285),anterior infarction (OR =4.419,95％ CI:2.645-7.384),heart rate ＞ 60 bpm (OR =3.32,95％ CI:1.898-5.808),killip class Ⅳ (OR =3.686,95％ CI:1.684-8.06),admission hemoglobin A1 c ＜ 5.6％ (OR =2.564,95％ CI:1.199-5.484),no use of ACEI (OR =1.827,95％ CI:1.099-3.038) and no use of lipid-lowing drugs (OR =2.034,95％ CI:1.196-3.458) were independent risk factors for short term mortality after STEMI.The receiver operating characteristic curve for predicting the death of the baseline and clinical variable models was 0.830 (95％ CI:0.796-0.865) and 0.866 (95％ CI:0.835-0.896),respectively.Conclusion The 30-day mortality of patients with STEMI complicated with fatal arrhythmia is high.Age,anterior infarction,heart rate ＞ 60 bpm,killip class Ⅳ,admission hemoglobin Alc level ＜ 5.6％,no use of ACEI and no use of lipid-lowing drugs are independent risk factors for 30-day mortality in these patients.
