Study On Clinical Characteristics And Treatments Of Acute Myocardial Infarction Patients Of Different Ages In Zhangjiakou Area

Object:The article investigates the clinical characteristics of acute myocardial infarction(AMI)patients with different ages in Zhangjiakou region,and also analyzes influence of ages on therapies,which offers great data and evidence in strategy making.Methods:1.Design a clinical data questionnaire for AMI patients,and input the medical records of patients that are diagnosed as AMI.These medical records which ranged from January 2014 to December 2016 were collected by cardiovascular physician from seven hospitals in Zhangjiakou region(including a top three hospital and six county hospitals).Based on the data,the AMI Excel database of AMI patients were established.2.634 patients were selected and were divided into 3 groups by their ages.These groups are adult group(age≤60 years),elder age(age of61 years to 80years),and advanced age group(age>80years).The clinical characteristics and treatment status of AMI patients of different ages were comparatively analyzed,which included gender,medical insurance,a way to the college,medical history,history of alcohol,tobacco,vital signs and laboratory indexes,treatment,prognosis,etc.Results:1.In 634 cases of AMI patients,adult group(age of 61 years to80years)had the most number of patients,up to 59.3%.With growth of age,the proportion of female patients significantly increased(from 12.3%to 47.6%).Rate of smoking and drinking showed obvious increasing trend(P<0.01).The proportion of elder group due to cerebral infarction is significantly higher than adult group(P<0.01).All three groups had the highest STEMI incidence(ST-segment elevation myocardial infarction).With increasing age,the proportion of extensive anterior myocardial infarction also increased.Proportion of Cardiac insufficiency increased gradually.The proportion of KillipⅡ-Ⅳ level in advanced age group was obviously higher than it in adult group and elder group.As age rises,BNP,systolic blood pressure and diastolic blood pressure showed decreasing trend.The proportion of people with systolic blood pressure lower than100 and diastolic blood pressure lower than 60 in advanced groups is obviously higher than that in adult group and elder group.With rising age,the BNP and homocysteine increased(P<0.05),and cholesterol and triglycerides,and hemoglobin decreased.The proportion of heart color E/A<1 in elder group and advanced group is significantly higher than that in adult group(P<0.01).2.Generally,the utilization rate of aspirin,clopidogrel,and low molecular heparin was insufficient,and the utilization rate of ACEI/ARB and β-blocker was low,which were 18.1% and 41.5%,respectively.With increasing age,utilization rate of aspirin,clopidogrel,statin load within 24 hours,low molecular heparin showed significant decrease(P<0.01).Also,utilization rate of Aspirin,clopidogrel,and β-blocker decreased(P<0.05),and Nitrate drugs increased greatly(P<0.05).3.With rising age,the incidence rate of heart failure increased(P<0.05).Transferred to higher level hospitals(PCI or CABG)decreased gradually(P<0.01).The number of days in hospital in advanced age group is higher than adult group(P<0.05).Conclusion:1.As age rises,the AMI in female increases,and the proportion of women with history of stroke,hyperlipidemia and anemia also increases.2.Compared with the young patients with AMI,older patients are much more serious,and have more complications,larger gap between treatment options and 《guidance》,longer time in hospital and poorer prognosis.