Epidemiological And Clinical Characteristics Of 555 Patients With Acute Myocardial Infarction In Shenzhen

Objective To study the epidemiological and clinical characteristics of acute myocardial infarction(AMI)patients in Shenzhen,to understand their three distributions,medical history,laboratory examination and characteristics of diseased blood vessels,and to analyze their regularity,so as to improve the early diagnosis rate of AMI by medical staff,and reduce the case fatality rate,and improve the prognosis.Method Selection on January 1,2019 to December 31,2019,Peking University Shenzhen hospital emergency department accepts and hospital,555 cases of AMI patients,the center data platform by chest pain and outpatient and inpatient medical records to collect data,observe its population distribution,time distribution,spatial distribution,history data,laboratory examination and lesion blood vessel condition index,and all patients were divided into non-ST-segment elevation myocardial infarction(NSTEMI)patients group and ST-segment elevation myocardial infarction(STEMI)patients group,compared to two group of patients with related indicators.SPSS 17.0 statistical software was used for data processing.Result There were 400 males(72.07%)and 155 females(27.93%)with AMI.There were 256 males(69.00%)in the NSTEMI group and 114 males(78.26%)in the STEMI group,main of which were male.The average age was 62.93±14.92 years,64.44±14.89 years in the NSTEMI group,59.88±14.59 years in the STEMI group,and the NSTEMI patients were older than the STEMI patients.The incidence was more in winter and spring,158 cases(28.47%)and 138 cases(24.86%),and less in summer and autumn,130 cases(23.42%)and 129 cases(23.24%),respectively.The number of cases in the STEMI group was less seasonal.By month division,with January,March,May and December more,November at least;The number of cases and the number of visits were the highest between 08:00 and 15:59,followed by between 16:00 and 23:59,and the lowest between 00:00 and 07:59.The median time from onset to treatment was 4.5(1.125-17.5).The incidence location of AMI patients was the most common at home,with a total of 473 cases(85.23%).A total of 426 patients(76.76%)came to the hospital by themselves,and 82(14.77%)and 47(8.47%)were transferred by ambulance.The proportion of patients in the STEMI group who did not come to hospital by themselves was higher than that in the NSTEMI group.The majority of AMI patients had no inducement,with a total of 408(73.51%).The common inducement was activity and exercise,with 52(9.37%)and 30(5.41%)cases,respectively.The main symptoms of intermittent or persistent chest pain were 222 patients(40.00%)and 220(39.64%),respectively.In the NSTEMI group,the main symptoms were intermittent chest pain(50.94%).In the STEMI group,123 patients(66.85%)had persistent chest tightness and pain.The history of hypertension was the most common,with a total of 328 cases(59.10%).The incidence of hypertension and coronary heart disease was higher in the NSTEMI group,and the incidence of smoking was higher in the STEMI group.The median white blood cell count(×109/L)in AMI patients was 9.07(7.10-11.29),and the total number of white blood cells in STEMI group was higher.The median D-Dimer value(mg/L)was 0.49(0.31-1.17),and the D-Dimer value was higher in the NSTEMI group.The median blood glucose value(mmol/L)was 7.13(5.89-9.50),which was higher in the STEMI group.The mean/median(mmol/L)values of cholesterol,triglycerides,LDL-C,and HDL-C were 4.54± 1.26,1.48(1.11-2.10),3.11±0.98,and 0.99±0.23,respectively.The cholesterol and LDL-C values were higher in the STEMI group.There were 26 cases(6.03%),78 cases(18.10%),87 cases(20.19%)and 240 cases(55.68%)of patients with AMI with 0,1,2 and 3 vessels,respectively.Among the vascular lesions,the proportion of anterior descending branch(LAD)was the highest,with a total of 385 cases(89.33%).The most common infarct sites of STEMI patients were the anterior and inferior walls,71 cases(38.59%)and 45 cases(24.46%),respectively.The most common criminal vessel was the LAD(58.43%),followed by the right coronary artery(RCA),62 cases(34.83%).Conclusion There are regional epidemiological and clinical characteristics of acute myocardial infarction patients in Shenzhen.As emergency workers,we should pay attention to the epidemiology and clinical features of acute myocardial infarction,strengthen health education for high-risk groups,pay attention to the performance of high-risk patients with AMI,and take appropriate treatment to improve the prognosis.