Cohort Study Of Endpiont Events Occurrence Of238Patients With Myocardial Infarction In The Hospital Of Traditional Chinese Medicine

The First Part：Literature Survey to Evaluate The Clinical Efficacy of MyocardialInfarction EndpointObjectivesInvestigate myocardial infarction clinical research literature about the usage of theend index, to the end of the myocardial infarction clinical curative effect evaluation indexset, the end of the evaluation indexes for construction of myocardial infarction, traditionalChinese medicine treatment.MethodsRetrieve CBM, CNKI, PubMed database by computer from January1,2003toDecember31,2012, clinical research literature related to myocardial infarction. Selectioncontains the end index evaluation literature, rule out the study of poor quality. Makingmyocardial infarction end index literature survey, myocardial infarction, end indexliterature database, statistical analysis of a single index, the primary end point, secondaryend points and different observation period end choice of indicators.ResultsInto the156references, collecting index, a total of36kinds of myocardial infarctionclinical end points. Analysis shows that the number of domestic terminal evaluation reporthas been rising trend year by year. The end of the most often choose indicators (19.7%),followed by recurrence myocardial infarction (15.7%), heart failure for all-cause mortality(9.3%), etc.; Choose the primary end point for recurrence (21.4%), myocardial infarction(18.2%) for all-cause mortality, cardiac death (10.5%), etc; secondary end points forrecurrence (14.9%), stroke, myocardial infarction (11.6%), heart failure (11.1%), etc. Inacute stage (28days) of the study often choose the end of the indexes for the recurrence ofmyocardial infarction (19.1%),(14.4%) for all-cause mortality, angina pectoris afterinfarction (8.3%), etc; discharge follow-up for1year of study often choose again hair (18.0%), myocardial infarction (13.1%), heart failure for all-cause mortality (12.6%), etc;in the follow-up period for more than a year of research is often selected recurrence(17.8%), myocardial infarction (12.8%) for all-cause mortality, again reascularization(11.0%), etc.ConclusionAccording to the survey, to obtain the study looked at the end of the collection.Hospital cardiac death, stroke, infarction, again reascularization, severe arrhythmia, cardiacshock, cardiac arrest, acute heart failure, acute renal failure, low blood pressure, pulmonaryembolism, cardiac rupture and bleeding as end point events; Follow-up period selectionand infarction, cardiac death, reascularization, severe arrhythmia, heart failure, againreascularization, stroke, cardiac arrest, cardiac shock, low blood pressure, bleeding, tumor,readmission as end point events.The Second Part：Study on the Occurrence of Events Queue during Hospitalization inPatients with Myocardial InfarctionObjectivesObserve the end point events during the period of hospitalization in patients withmyocardial infarction (mi), for the myocardial infarction curative effect of Chinesemedicine provides the basis for the construction of evaluation index at the end. To explorehospital of traditional Chinese medicine therapy and myocardial infarction, end therelationship of events produce evidence of evidence-based medicine.MethodsMake the Chinese medicine hospital patients with myocardial infarction (mi) researchquestionnaire. Through the hospital medical record information management system, selectthe affiliated hospital of shandong university of TCM on January1,2008to December31,2012,238cases of hospitalized patients with myocardial infarction cases investigation.Collect clinical characteristics, the usage of traditional Chinese medicine and the end pointevents happening. Choose Epidata software, the establishment of TCM hospital cohortstudy on myocardial infarction patients in hospital information database, input data. Caseson the basis of traditional Chinese medicine intervention time divided into differentintensity of exposure group, the statistical exposed groups each end point events happening,and USES the multi-factor logistic regression analysis to deal with the data got intensity ofintervention of traditional Chinese medicine with the end point event occurs.Results1. The finish sorting events happening frequencies for acute heart failure (22.34%),cardiac death (20.30%), cardiac shock (16.24%), severe arrhythmia (12.18%),reascularization (10.15%), low blood pressure,7.61%), cardiac arrest (5.58%), andinfarction (3.55%), stroke (0.51%), acute renal failure (0.51%), pulmonary embolism(0.51%), bleeding (0.51%). Intervention of comparative advantage of Chinese medicinesorting: cardiac death, cardiac shock, acute heart failure, cardiac arrest, hypotension, reascularization and infarction, stroke, acute renal failure, pulmonary embolism, cardiacrupture, severe arrhythmia, bleeding; Preliminary build of myocardial infarction, hospitalevaluation index at the end: the primary end point index for cardiac death, infarction, acuteheart failure, stroke for secondary end points, cardiac shock, serious arrhythmia.2. The Logistic analysis of TCM intervention (OR=7.753), age (OR=1.230) is acardiac death related factors; Age (OR=1.055) is associated with acute heart failurefactors; Age (OR=1.072) is a cardiac shock related factors, antithrombotic drugs (OR=0.171) are negatively related with cardiac shock; To analyze the related factors toinfarction and stroke.ConclusionHospital of traditional Chinese medicine in the prevention of myocardial infarctionpatients cardiac death, cardiac shock, acute heart failure, cardiac arrest is shown on the endpoint events such as advantage, statistical analysis showed that TCM intervention canreduce the in-hospital cardiac death in patients with myocardial infarction (mi).The Third Part：Cohort Study of Patients with Myocardial Infarction Occurredduring the Follow-up OutcomeObjectivesTo observe the myocardial infarction patients discharged from hospital and the endpoint events during the period of follow-up for myocardial infarction curative effect oftraditional Chinese medicine provides the basis for the construction of evaluation index atthe end. Discharge treatment of Chinese medicine during the follow-up period and end therelationship of myocardial infarction (mi), produce evidence of evidence-based medicine.MethodsInvestigation into the case of hospital information follow-up, time since the date ofthe records of discharged to December21,2012, way is given priority to with telephonefollow-up. End point events in patients with collection and usage of Chinese medicine, andfill in the Chinese medicine hospital patients with myocardial infarction (mi) cohort studyquestionnaire follow-up section, choose Epidata software, establish a cohort study onmyocardial infarction patients in hospital of traditional Chinese medicine hospitalinformation database, input data. Based on the cases of patients discharged from hospital oftraditional Chinese medicine treatment time divided into different intensity of exposuregroup. Statistical exposed groups each end point events happening, and USES themulti-factor logistic regression analysis data for treatment of traditional Chinese medicinestrength relationship with the end point events.Results1. The finish sorting events happening frequencies for cardiovascular readmission(30.19%), cardiac death (25.16%), heart failure (13.84%) and infarction (9.43%),reascularization (7.55%), severe arrhythmia (6.29%), stroke (3.14%), cardiac arrest(1.26%), low blood pressure (1.26%), tumor (1.26%), cardiac shock (0.63%). Intervention of comparative advantage of Chinese medicine sorting: cardiac death, acute heart failure,infarction, cardiac arrest, tumor, again again reascularization, hemorrhage, stroke, seriouscardiac arrhythmias, cardiac shock, low blood pressure, blood supply reconstruction,cardiovascular readmission; Preliminary build of myocardial infarction, hospital evaluationindex at the end: the primary end point index for cardiac death, acute heart failure,infarction, secondary end points index for readmission, cerebral apoplexy, reascularization,serious arrhythmia.2. The Logistic analysis of antithrombotic drugs (OR=2.831), lipid-lowering drugs(OR=2.696), abnormal blood sugar (OR=2.734), the intensity of intervention oftraditional Chinese medicine (OR=1.528), age (OR=1.053) is a cardiac death relatedfactors; Abnormal blood sugar (OR=2.793), the intensity of intervention of traditionalChinese medicine (OR=1.587), age (OR=1.054) is the onset of heart failure relatedfactors; Age (OR=1.074) is a serious arrhythmia related factors; Again failed to analyzeinfarction, cerebral apoplexy and the related factors of reascularization.ConclusionOf traditional Chinese medicine in the prevention of most death HouXin source sexmyocardial infarction (mi), acute heart failure, and then infarction, cardiac arrest is shownon the end point events such as advantage, statistical analysis shows that TCM interventioncan effectively reduce the myocardial infarction patients with cardiac mortality, and canprevent the onset of heart failure, would be helpful for improving the prognosis of patientswith myocardial infarction.