The Study About Clinical Prognosis Of The Patients With Non-ST-segment Elevation Myocardial Infarction

Objective:To study acute and long-term prognostic factors and the risk in patients with non-ST-segment elevation myocardial infarction (NSTEMI).Method:One hundred and sixty NSTEMI patients admitted into our hospital from December2008to December2009were consecutively included in this study. Average age in our study was65.7±11.5years old (age range37-88years), of which over65years-old elderly patients were94persons (58.8%). The inclusion criteria was patients with persistent chest pain and confirmed NSTEMI diagnosed by the ECG and the myocardial necrosis markers. Meanwhile exclude the early repolarization syndrome, acute pericarditis, cerebral hemorrhage, electrolyte disorders and drug influence, get patients information by review patient medical record, include laboratory test results, echocardiography, and coronary angiography imaging data as well as drug and revascularization treatment.12-24months follow-up of the cardiovascular events was conducted, including the major event (cardiac death) and the minor complex cardiovascular events (non-fatal myocardial infarction, revascularization and rehospitalization due to coronary heart disease). In order to clarify the long-term risk factors for cardiac events, study population was divided into difference subgroup according to gender, age, renal function, left ventricular ejection fraction, hypertension, diabetes, hyperlipidemia. et al.Result:During the12-24months of follow-up, compliance of drug therapy in patients has declined markedly. During hospitalization and follow-up period, the percentage of drug application respectively is:aspirin (93.8%:74.0%), Clopidogrel (92.5%:53.2%), statin drugs (95.0%:62.3%), Beta-blocker (76.3%:44.2%) and angiotensin converting enzyme inhibitors (ACEI) and angiotensin-receptor blockers(ARB)(67.5%:38.9%). There were64cases of cardiovascular events during follow-up (41.6%), including the major cardiovascular events (death) in26cases (16.9%), minor combined cardiovascular events in38cases (24.7%). Comparative results of different subgroups, over65years old, renal failure, with left ventricular ejection fraction of less than50%, the main and minor complex cardio-vascular events were significantly higher than the control group. And the subgroup of revascularization during hospitalization, the incidence of major cardiovascular events and minor complex cardiovascular events was significantly lower.Conclusion:prognosis of NSTEMI patients is bad with short-term and long-term follow-up. A higher proportion of death, re-hospitalization and revascularization has been observed. In particular, older than65years of age, renal insufficiency, ejection fraction less than50%of patients with a worse prognosis. Revascularization during hospitalization can effectively reduce the occurrence of cardiovascular events.