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Correlation between Clinical Features on Admission and Adverse Outcomes during Hospital Stay among Patients with Acute Myocardial Infarction

Author: XuFeng
Tutor: ChenJianChang
School: Suzhou University
Course: Cardiology
Keywords: acute myocardial infarction gender age cardiac function group riskratio
CLC: R542.22
Type: Master's thesis
Year: 2012
Downloads: 63
Quote: 0
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Abstract


Objective: Acute myocardial infarction (AMI) is a common cardiovascular diseasewhich is caused by many sorts of risk factors.The more risk factors,the speedierdevelopment into coronary heart disease. In this study, the aim was to investigate thecorrelation between AMI patients clinical features on admission and adverse outcomesincluding Killip class Ⅲ and Killip class Ⅳ at hospital discharge,death event andcomposite outcome which is those combined during hospital stay through casessurvey,which providing the theoretical basis for AMI treatment strategy.Methods: A total of849subjects which were AMI onset for the first time wereselected.Demographic data,biochemical indicators such as blood pressure,heartrate,complication,myocardial infarction location, serum lipids,serum uric acid,C-reactiveprotein level, and data about cardiac function Killip class Ⅲ and Killip class Ⅳ at hospitaldischarge,in-patient death were collected for all subjects.To analyse demographiccharacter, past history, clinical features determined on admission obtained from a total of849subjects under different gender,age,cardiac function,complication positive ornegative,composite outcome positive or negative groups,and estimate the risk ratios ofclinical features on admission to cardiac function Killip class Ⅲ and Killip class Ⅳ athospital discharge, death event and composite outcome during hospital stay.Results:1)There were648cases of male AMI patients(76.33%) and201cases offemale(23.67%),and ratio between them was3.22:1. Significant differences of age,diabetic mellitus history,systolic blood pressure,pulse pressure,complication,totalcholesterol,high density lipoprotein-c level were observed female group above malegroup,respectively. Significant differences of civil service, smoking history,drinkinghistory,uric acid level were observed female group below male group,respectively. 2)Significant differences of civil service,smoking history,drinking history,diastolicblood pressure,mean arterial pressure,triglyceride level were observed<60-years-oldgroup above>60-years-old group,respectively. Significant differences of coronaryheart disease history,hypertension history, diabetic mellitus history,cerebral stroke history,complication,acute endocardium myocardial infarction, pulse pressure,uric acid,C-reactiveprotein level were observed<60-years-old group below>60-years-oldgroup,respectively.3) By univariate logistic analysis,there were significant associations betweenextensive anterior wall MI and cardiac function Killip class Ⅲ and Killip class Ⅳ athospital discharge, death event or composite outcome during hospital stay,respectively.Butthe ORs were not significant after adjusted for multivariate. By univariate logisticanalysis,there were significant associations between low density lipoprotein-c level andcardiac function Killip class Ⅲ and Killip class Ⅳ at hospital discharge, death event orcomposite outcome during hospital stay,respectively.But the ORs were not significant afteradjusted for multivariate. By univariate logistic analysis,there were significant associationsbetween total cholesterol, C-reactive protein and death event during hospitalstay,respectively.But the ORs were not significant after adjusted for multivariate. Multipleadjustment by risk factors including age, smoking, alcohol intake, et al demonstrated that asignificant association was still persisted between complication,heart rate,uric acid andcardiac function Killip class Ⅲ and Killip class Ⅳat hospital discharge, death event orcomposite outcome during hospital stay,respectively. Multiple adjustment by risk factorsincluding age, smoking, alcohol intake, et al demonstrated that a significant associationwas still persisted between C-reactive protein level and cardiac function Killip class Ⅲ andKillip class Ⅳat hospital discharge, or composite outcome during hospitalstay,respectively.Conclusion:1)The incidence of complication,composite outcome increased obviously in AMIpatients with lower levels of systolic blood pressure, diastolic blood pressure, pulse pressure,mean arterial pressure on admission,respectively.2)Heart rate,uric acid levels on admission were independent predictors of cardiacfunction Killip class Ⅲ and Killip class Ⅳ at hospital discharge, death event duringhospital stay,respectively.3)C-reactive protein level was predictor of death event during hospital stay.C-reactiveprotein level was risk predictor of inpatient adverse outcomes.

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CLC: > Medicine, health > Internal Medicine > Heart, blood vessels ( circulatory ) disease > Heart disease > Myocardial diseases > Myocardial infarction
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