Association Of The Heart Rate And Glomerular Filtration Rate In Patients With Acute Myocardial Infaration

Objective: To analyze the correlation between the heart rate and glomerular filtration rate of acute myocardial infarction patientMethod: the experimental group is determined through selecting 420 patients, which are diagnosed as with acute myocardial infarction, of which information of serum creatinine value and 24-hour dynamic electrocardiogram are detailed, and which are hospitalized within 24 hours of onset in Loudi Central Hospital and Loudi Second Hospital from January 2013 to December 2014, and after excluding 115 patients. In the meantime, comparison group is collected through selecting 202 cases of people without organic disease after physical examination in Health Examination Center of Loudi Central Hospital. After then, this research collects serum creatinine value, age, gender, weight, blood pressure, blood fat and fasting blood glucose and parallel 24-hour dynamic electrocardiogram of patients within 24 hours after admission and records the patients’ past medical history. One day after admission, the fasting venous blood of all patients are obtained to detect TC, LDL-C, TG, HDL-C, serum creatinine value and urea nitrogen. Their glomerular filtration rate is calculated by MDRD equation. The patients will be divided into three groups according to glomerular filtration rate: normal group(eGFR> 90 ml / min/1.73 m2), slightly decreased group(eGFR60-89 ml/min/1 73 m2) and moderately or severely decreased group(eGFR<60 ml / min/1.73m2). The differences of heart rate among these three groups are compared. According to the results of 24-hour dynamic electrocardiogram of patients, the patients are divided into three groups by their average heart rate: <70 times/group, between 70 times and 90 times/group, and >90/group. By applying one-way analysis of variance, the result that the difference of systolic pressure, diastolic blood pressure, fasting glucose, creatinine, urea nitrogen, CHOL, HDL-C and eGFR and such indexes of two groups have statistical significance is obtained. The result is applied by the model, which analyzes whether the correlation between heart rate and glomerular filtration rate of patients with acute myocardial infarction exists by non-condition logistic regression analysis to, and analyzes the correlation between glomerular filtration rate and cardiovascular risk factors. In addition, it compares the statistical difference of glomerular filtration rate and urea nitrogen, and glomerular filtration rate and creatinine among three groups.Result: 1. The difference of age and LDL-C of experimental comparison groups is not statistically significant. The difference of systolic pressure, diastolic blood pressure, fasting glucose, creatinine, urea nitrogen, CHOL, HDL-C and such indexes of two groups have statistical significance. Distribution and composition differences of two groups’ eGFR have statistical significance, while no statistical significance can be obtained from difference of heart rate distribution between two groups.2. Diastolic blood pressure and fasting plasma glucose are both dangerous factors of myocardial infarction. eGFR and HDL-C are protective factors of myocardial infarction. When diastolic blood pressure increases 1 unit, the risk of having myocardial infarction would increase 1.137 times; when fasting plasma glucose increases 1 unit, the risk of having myocardial infarction would increase 4.801 times; when eGFR increases 1 unit, the risk of having myocardial infarction would become 0.606 times of the previous one; when HDL-C increases 1 unit, the risk of having myocardial infarction would become 0.146 times of the previous one;3. There is significant correlation between eGFR and age, systolic blood pressure, creatinine, urea nitrogen, LDL-C and heart rate.4. The differences of eGFR, urea nitrogen and creatinine in different heart rate groups all have statistical significance. As heart rate increases gradually, glomerular filtration rate is on a declining curve, and urea nitrogen and creatinine are on an rising curve.Conclusion: Conclusion: there is certain negative correlation between heart rate and glomerular filtration rate of patients with acute myocardial infarction. There is certain relevance between decrease of glomerular filtration rate and acute myocardial infarction.