Clinical Characteristics And Prognostic Factors Of Patients With Ischemic Cardiomyopathy

Objective: This study attempts to investigate the clinical features of hospitalized patients with Ischemic cardiomyopath(ICM)through a retrospective study of the medical records,and to explore the related factors and independent risk factors of all-cause death in 1 year,providing a useful guide for the clinical prevention and treatment of ischemic cardiomyopathy.Methods: It was retrospectively analyzed that involve schemic cardiomyopath patients who were treated in the First Hospital of Jilin University from January 1,2014-November 31,2015.Analysis of the patient's age,gender,past medical history,vital signs,treatments,and auxiliary inspection results in order to find out the differences In NYHA class III,and NYHA class IV.Then following-up for 1 year survival situation,the patients were divided into the event group and the non-event group for all-cause mortality,analysis two sets of data on a single factor,screening possible risk factors of all-cause mortality.Then collect related risk factors(P <0.05)into multivariate Logistic regression analysis to discovery independent risk factors for all-cause mortality?Reasults: 1.Of 363 patients with NYHA functional class data at admission and in-hospital data,307(84.57%)patients with complete 1 year survival status follow-up,were included in the present analysis,including 189 males and 118 females.NYHA class III,and IV at admission were observed in 65.7 % and 44.3% of the patients,respectively.The mean length of hospital stay was 8(8.04±4.36)days,while the all-cause mortality rate was 37.67%.2.Patients with NYHA class IV were more likely to have an diabetes mellitus complications,compared to those with NYHA class II or III,and differences between the two groups was statistically significant(P < 0.05).Patients with NYHA class IVhad significantly longer left atrial diameter and higher heart rate.In laboratory tests,lower Hemoglobin level,lower serum sodium slevel,lower Serum albumin level,higher Serum creatinine level,and higher White blood cell level,were observed in patients with NYHA class IV than in those with NYHA class III,and differences between the two groups was statistically significant(P < 0.05),the mean length of hospital stay was longer in patients with NYHA class IV than in those with NYHA class III(P < 0.05).3.The all-cause death rate was significantly higher in patients with NYHA class IV(70.24%)than in those with NYHA class III(29.76%)(P < 0.001).Univariate analysis showed that the influence of factors on all-cause death were Age(P=0.009),BMI(P=0.013),ventricular arrhythmia(P=0.0.021),blood pressure(P=0.047),serum albumin level(P=0.000),Serum alkaline phosphatase levels(P=0.000),lymphocyte percentage(P=0.001),hemoglobin levels(P=0.001),Red blood cell distribution width,serum sodium level(P=0.000),glomerular filtration rate(P=0.002),left atrial diameter(P=0.001)and left atrial diameter index(P=0.000).4.However,in multivariate analysis,only ventricular arrhythmia,serum alkaline phosphatase,serum albumin levels,lymphocyte percentage,left atrial diameter indexwere the independent risk factors of all-cause mortality.5.The survival rate of one group with MUSIC risk score > 20.5 significantly decreased,compared with another group with MUSIC risk score <20.5,and the differences between the two groups have statistical significance(P < 0.05).Conclusion: ? With the heart function deterioration,patients with a higher NYHA class had higher heart rate,longer mean length of hospital stay,lower hemoglobin levels,higher all-cause death rate higher and longer left atrial diameter.Impairment of renal and hepatic function is related to New York Heart Association functional class symptoms status.2.The incidence of all-cause mortality was up to 37.67% in one year.Serum albumin,ventricular arrhythmias,serum alkaline phosphatase level,serum albumin level,lymphocyte percentage,left atrial diameter index is independent risk factor of death.3.Music score has a certain predictive value for the prognosis of patients withischemic cardiomyopathy in NYHA class III and IV,and a poor prognosis in patients with Music risk score> 20.5 points.