A Study Of The Risk Factors For Patients With Acute Coronary Syndrome At Early Stage

Objective:To explore the prognostic risk factors for patients with ACS at early stage.Methods:555hospitalized cases of acute coronary syndrome were randomly selected from thedatabase of our hospital according to hospital number from January2006to December2009，inwhich209cases were STEMI (37.7%)，346cases were NSTE-ACS (62.3%)． Followed up for30days and recorded the ending-point events. In order to screen risk factors for patients withacute coronary syndrome at early stage，clinical data was collected and then analyzed bystepwise multiple linear regressions with efficacy as the dependent variable，gender，age，hypertension，the class of heart function，NT-proBNP，number of diseased vessels，renalinsufficiency on admission，decrease of renal function after treatment，PCI，primary PCI，baseline LDL-C on admission，cardiac shock，IABP，heart rate on admission as the independentvariables．Results:A total of554patients with ACS complete the30-day follow-up，age range35to100years，median74years，321cases were male［（69.2±12.0）years］，234cases were female［（76.5±9.7）years］．209cases were the type of STEMI (37.7%)，345cases were the type ofNSTE-ACS(62.3%)．During the30-day follow-up，all-cause death cases were157(28.3%，73cases male，84cases female) of which cardiac shock cases is15，recurrent myocardial infarctioncases is1，arrhythmias cases is37，sudden death cases is6，acute heart failure cases is101，stoke cases is6and angina accompanied by ECG ischemic change cases is36．The Logisticregression analysis of the all-cause death of the STEMI patients showed： age （OR=1.044,95%CI:1.00-1.09,P=0.031）、 number of diseased vessels （OR=1.695,95%CI:1.05-2.74,P=0.031）、heart shock within24hours on admission （OR=5.852,95%CI:1.28-26.77,P=0.023）are the independent risk factors of the short term mortality; baseline LDL-C on admission（OR=0.290,95%CI:0.120-0.697，P=0.006）、PCI（OR=0.168,95%CI:0.054-0.522,P=0.002）are the protective factors of the short term mortality．The Logisticregression analysis of the all-cause death of the NSTE-ACS patients showed：female（OR=2.265，95%CI:1.25-4.12，P=0.007），the class of heart function（OR=1.87，95%CI：1.36-2.59，P<0.001），number of diseased vessels（OR=1.70，95%CI：1.14-2.54，P=0.01），renal insufficiency on admission（OR=2.96，95%CI：1.60-5.48，P=0.001）are the independentrisk factors of the short term mortality，PCI(OR=0.10，95%CI：0.04-0.23，P＜0.001) andbaseline LDL-C on admission(OR=0.52，95%CI：0.28-1.0，P=0.047) are the protective factorsof the short term mortality．Conclusion:1. In the STEMI group：age,number of diseased vessels, heart shock within24hours onadmission,IABP are the independent risk factors of the short term mortality．2. In the NSTE-ACS group：female，the class of heart function，the number of diseasedvessels，Renal insufficiency on admission are the independent risk factors of the short termmortality．3. In the NSTE-ACS group：PCI, baseline LDL-C on admission are the protective factors ofthe short term mortality．4. In the STEMI group：PCI, baseline LDL-C on admission are the protective factors of theshort term mortality．...