摘要
目的探讨ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)术后新发心房颤动(NOAF)的影响因素,为预防STEMI患者PCI术后NOAF提供参考依据。方法选取2020年2月至2023年2月河南科技大学第一附属医院收治的512例行PCI术的STEMI患者为研究对象,所有患者PCI术后均随访1年,根据随访期间患者是否NOAF分为NOAF组(51例)和n-NOAF组(461例)。STEMI患者PCI术后NOAF的影响因素采用单因素和多因素分析,并构建预测模型分析其预测价值。结果年龄较大、SYNTAX积分较高、左心房内径较大、术后无复流、血清CRP、NT-proBNP水平较高均为STEMI患者PCI术后NOAF的独立危险因素(OR=1.621、1.840、1.611、1.772、1.603、1.732,P<0.05)。ROC曲线分析结果显示,预测模型预测STEMI患者PCI术后NOAF的曲线下面积(AUC)为0.873,敏感度为82.35%,特异度为84.60%。结论STEMI患者PCI术后NOAF的独立危险因素包括年龄较大、SYNTAX积分较高、左心房内径较大、术后无复流、血清CRP、NT-proBNP水平较高,据此构建的预测模型预测价值较好,因此临床可对有上述特征的患者进行针对性治疗或干预,以降低患者NOAF的风险。
Objective To study the influencing factors of new-onset atrial fibrillation(NOAF)after percutaneous coronary intervention(PCI)in patients with ST-segment elevation myocardial infarction(STEMI),so as to provide reference and basis for preventing NOAF after PCI in patients with STEMI.Methods A total of 512 patients with STEMI who underwent PCI in the First Affiliated Hospital of Henan University of Science and Technology from February 2020 to February 2023 were selected as the study objects.All the patients were followed up for 1 year after PCI.According to whether the patients had NOAF during the follow-up period,they were divided into the NOAF group(n=51)and the n-NOAF group(n=461).Univariate and multivariate analysis were used to analyze the influencing factors of NOAF after PCI in patients with STEMI.A prediction model was constructed and its predictive value was analyzed.Results Higher age,higher Synergy Between PCI with Taxus and Cardiac Surgery(SYNTAX)score,higher left atrial diameter,no reflow after operation,higher levels of serum C-reactive protein(CRP)and N-terminal pro-B-type natriuretic peptide(NT-proBNP)were independent risk factors for NOAF after PCI in patients with STEMI(OR=1.621,1.840,1.611,1.772,1.603,1.732,P<0.05).The results of receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)of the prediction model for predicting NOAF after PCI in patients with STEMI was 0.873,the sensitivity was 82.35%,and the specificity was 84.60%.Conclusion The independent risk factors of NOAF after PCI in patients with STEMI include higher age,higher SYNTAX score,higher left atrial diameter,no reflow after operation,higher levels of serum CRP and NT-proBNP.The prediction model constructed based on the above factors exhibits good predictive value.Therefore,targeted treatment or intervention could be carried out for patients with the above characteristics to reduce the risk of NOAF.
作者
陈瑞晓
韩延辉
赵劲东
李炳强
普兆坤
Chen Ruixiao;HanYanhui;Zhao Jindong;Li Bingqiang;Pu Zhaokun(Department of Cardiology,College of Clinical Medicine,and The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,China)
出处
《成都医学院学报》
CAS
2024年第5期861-863,867,共4页
Journal of Chengdu Medical College
关键词
心肌梗死
ST段抬高型
经皮冠状动脉介入治疗
心房颤动
影响因素
预测模型
Myocardial infarction
ST-segment elevation type
Percutaneous coronary intervention
Atrial fibrillation
Influencing factor
Prediction model
