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Objective analysis of the clinical data of Tianjin Medical University Hospital treatment of primary PCI in patients with AMI, AMI patients with clinical features of different ages, and short-term prognosis analysis of AMI during hospitalization in patients with heart failure and heart event risk factors were analyzed and summarized to provide a basis to investigate the treatment of hospitalized patients with acute myocardial infarction strategy to improve the level of treatment. Methods A retrospective case analysis, selected from January 2000 to December 2007, the Second Hospital of Tianjin Medical University cardiologist consecutive patients undergoing emergency PCI treatment of 730 patients hospitalized with AMI. Patients admitted to hospital were divided into adult (lt; 50 years old) pre-elderly group (50-70 years old) and elderly group (gt; 70 years old), comparative analysis of clinical characteristics and differences in short-term prognosis; whether during hospitalization occurrence of cardiac dysfunction is divided into a group of heart failure and normal heart function group, comparative analysis of the two groups may affect the risk factors associated with cardiac dysfunction; adverse cardiac events occurred during hospitalization divided into group events and event group comparative analysis of the two groups may affect the risk factors associated with cardiac events. Results 1 enrolled 730 patients with an average age of 61.75 ± 10.81 years old (29-87 years old), the adult 111 cases, accounting for 15.21% of the total; pre-elderly group of 416 cases, accounting for 56.98% of the total; elderly group, 203 cases accounting for 27.71% of the total. (1) three groups of patients with a history of smoking, drinking history proportion decrease with age, female patient with a history of coronary heart disease, old myocardial infarction history of the proportion of age increased, the difference was statistically significant (P lt; 0.05); pre-elderly and elderly groups hypertension, stroke, and the proportion of anemia was significantly higher than the adult group, the differences were statistically significant (P lt; 0.05). (2) increased with age, the proportion of AMI patients the first symptoms of typical chest pain significantly reduced, and the differences were statistically significant (P lt; 0.05); the adult anterior myocardial infarction proportion significantly higher than the other two groups, the difference was statistically significant (P lt; 0.05). (3) increase with age, the patients with AMI pulse pressure difference gradually increases, the difference was statistically significant (P lt; 0.05); elderly group heart rate faster than the other two groups, the elderly group WBC was significantly higher than the other two groups, the blood K of the older group and the pre-elderly group was significantly higher than adult serum Na was significantly lower in the elderly group, adult the TG significantly higher than the other two groups, the elderly group, the GLU is significantly higher than the other two groups, and the differences were statistically significant (P lt ; 0.05); three groups of patients BUN increased with age gradually increased, HGB decreased, the difference was statistically significant (P lt; 0.05). (4) increase with age, the proportion of single-vessel disease gradually reduce the proportion of three-vessel disease gradually increased, the IRA as a the right coronary proportion gradually increased, preoperative blood flow TIMI 0 grade gradually increased, the difference was statistically significant (P lt; 0.05); IRA proportion of adult LAD significantly more than the other two groups, the difference was statistically significant (P lt; 0.05) (5) adult stent diameter is larger than the other two groups, the difference was statistically significant (P lt; 0.05); increased with age, the choice of stent length increases, the difference was statistically significant (P lt; 0.05) (6) As we age, the proportion of diuretics and digitalis preparations applications increases, the difference was statistically significant (P lt; 0.05). (7) The three groups of patients with increasing age LVEF gradually reduced, the difference was statistically significant (P lt; 0.05); pre-elderly and elderly groups LVEDD was significantly higher than that in adult patients, the difference was statistically significant (P lt; 0.05 ). (8) with age, heart failure, gradually increase the proportion of patients with lung infection and death, there were significant differences among the three groups (P lt; 0.05); proportion of gastrointestinal bleeding occurs in the elderly group was significantly increased, the difference was statistically significant (P lt; 0.05) 2 univariate analysis: age, gender, diabetes, lung infections, old myocardial infarction, preoperative blood flow TIMI scale, multi-vessel disease, heart rate, pulse pressure, LVEF, WBC, HGB, BUN, GLU, LDL-c the peak of CK, CK-MB peak and ΣSTI of influencing factors during hospitalization ventricular dysfunction. Logistic regression analysis showed that age, heart rate, CK-MB peak, admission GLU and ΣSTI an independent risk factor for heart failure during hospitalization. 3 Univariate analysis showed that: gender, age, heart rate, systolic blood pressure, diastolic blood pressure, pulse pressure, ΣSTI, high blood pressure, lung infection, hyperlipidemia, multi-site infarction of WBC, Fgb, Cr, Glu, CK peak CK-MB peak, HGB, Na, Cl, multivessel disease, IRA LAD, disease - balloon time and no-reflow postoperative risk factors for adverse cardiac events during hospitalization. Logistic regression analysis showed that age, admission GLU, FGB, CK-MB peak, multivessel disease, IRA LAD, incidence - balloon time and after no-reflow adverse cardiac events during hospitalization were independent risk factors. Conclusion 1. Elderly patients with AMI, the symptoms are not typical of the high incidence of hospital cardiac events and cardiac dysfunction and poor prognosis. The reason may be associated with disease, severe coronary artery disease, high pulse pressure, high white blood cell count, stress hyperglycemia and other factors. Can be clinically early detection of patients with coronary heart disease, to prevent the occurrence of AMI, for has occurred AMI patients, active intervention to prevent the occurrence of cardiac events and cardiac dysfunction, and improve the prognosis. Age, heart rate, CK-MB peak, admission GLU and ΣSTI an independent risk factor for heart failure during hospitalization. Age, admission GLU the FGB, CK-MB peak, multivessel disease, IRA LAD, incidence - balloon time and postoperative no-reflow AMI hospital adverse cardiac events were independent risk factors.
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