The Clinical Analysis Of Acute Myocardial Infarction In The Elderly

Objective To analysis the risk factors,the clinical manifestation,the arrhythmia outbreak situation,the outcomes of CAG and the peak of creatine kinase of patients with acute myocardial infarction,accordingly to summarize the clinical characteristics of the elderly as a special group with acute myocardial infarction.Materials and methods Retrospective analysis of 1015 people with acute myocardial infarction who are performed primary PCI in the Second Hospital of Tianjin Medical University from Jun.2000 to Oct.2008.They are divided into two groups according to the age≥60 year old:Old age group 587 examples,male 387 examples,female 200 examples;Non-old age group 428 examples,male 377 examples,female 51 examples.Compares two groups of risk factors,the clinical manifestation,the arrythmia outbreak situation,the outcomes of CAG and the peak of creatine kinase difference,thus summarizes two group of patient's clinical characteristic difference.Results 1 the risk factor:The sex and the smoking history difference of the old age group and the non-old age group have statistics significance(P＜0.05). Hypertension,diabetes and the hyperlipemia and so on risk factor comparison,the differences of two groups do not have statistics significance(P＞0.05).In has in similarly the above three kind of risk factor crowd,has statistics significance compared with the old age group and the non-old age group's CAG result difference(P＜0.05).2 The preinfarction angina pectoris formation rate differences of the old age group and the non-old age group do not have statistics significance(P＞0.05).The typical angina pectoris's formation rate differences of two groups have statistics significance(P＜0.05).The heart function KILLP graduation(the KillipⅠ,the KillipⅡ, Killip≥Ⅲ) differences of the old age group and the non-old age group have statistics significance(P＜0.05).3 The atrial premature beats,atrial fibrillation,two degree above atrioventricular and premature ventricular beats formation rate comparison differences of the old age group and the non-old age group have statistics significance(P＜0.05).The difference of the ventricular tachycardia and ventricular fibrillation formation rate does not have statistics significance(P＞0.05).4 The infarction related artery distribution comparison differences of the old age group and the non-old age group do not have statistics significance(P＞0.05).The old age group and the non-old age group CAG result comparison difference has statistics significance(P＜0.05).5 Compare the difference of creatine kinase peak(CK＞upper limit 2 times,CK＞1000U/L,CK＞2000U/L) of the old age group and the non-old age group do not have statistics significance(P＞0.05).Conclusion(1) The female patients of the old age group with acute myocardial infarction compare with the non-old age group increase obviously,but the male patients are still crowd's majority.The old age patients with acute myocardial infarction suffer from hypertension,diabetes and hyperlipemia's probability does not have the difference with the non-old age group,but to compare with the non-old age group who have the similarly hazard factors,the old age group CAG results have relatively serious blood vessel pathological change.(2) The preinfarction angina pectoris formation rate of the old age group do not have the difference with the non-old age group,but after acute myocardial infarction, the typical angina pectoris's formation rate is low,namely the senior citizen indolence myocardial infarction formation rate is high.After acute myocardial infarction,the heart function of the senior citizen is bad.(3) The atrial premature beats,atrial fibrillation,two degree above atrioventricular and premature ventricular beats formation rates of acute myocardial infarction in the elderly are high.(4) The infarction related artery distribution of the elderly does not have difference comparing with the non-old age group,the elderly CAG results have relatively serious blood vessel pathological change.(5) The senior citizen and the non-senior citizen creatine kinase peak value does not have the difference.