| Objective: For women especially the clinical features of elderly women with acute myocardial infarction were analyzed retrospectively,to investigate the clinical characteristics of elderly female patients with acute myocardial infarction complicated with acute heart failure,to understand the pathological characteristics and main influencing factors,for the two grade prevention in such patients,the clinical valuable information,to provide reference information for clinical and clinical basis for standardization treatment and individualized treatment,and provide clinical reference for improving prognosis in elderly female patients with acute myocardial infarction.Methods: In the analysis method from May 2015 to August 2017 in consecutive female patients with acute myocardial infarction who were admitted to the First Affiliated Hospital of China Medical University review,according to the WHO are in different age divided into young women 46 cases in A1 group(15-59 years old)and older women in167 cases of group A2(60-89 years),a total of 213 female patients;according to the different levels of BNP were divided into three groups,81 cases in B1 group(BNP<100pg/ml),89 cases of group B2(100 BNP<500 pg/ml),43 cases of group B3(BNP = 500pg/ml).The clinical data,the results of echocardiography,the results of coronary angiography and the clinical events were counted and the results were statistically analyzed.Results: 1,general: A1 group A2 group of elderly women and young women systolic and diastolic blood pressure,smoking history,diabetes history,past history of stroke,previous myocardial infarction,renal insufficiency,previous history of heart failure case history was no difference in heart rate,(P>0.05),2 echocardiography: young female A1 group and female elderly patients in group A2 were with elevated BNP levels,left ventricular end systolic diameter(LVESD)and left ventricular end diastolic diameter(LVEDD)increased,ejection fraction(LVEF)decreased;and in the B3 group and B1 group and B2 group compared with statistical the difference(P<0.05),but in group B2 and B1 had no difference(P>0.05).It is suggested that BNP level can reflect the size of heart cavity and cardiac function after acute myocardial infarction in women,and the higher the significance of BNP is.A2 group of different BNP levels of LVESD,LVEDD and A1 group compared with B1,B2 group increased,B3 decreased;EF value compared with the A1 group B1 group decreased,B2 and B3 group increased,but the difference was not statistically significant(P>0.05)(see Table 3),suggesting that older women appear heart enlargement after acute myocardial infarction as early as in young women,but the occurrence of severe heart failure in elderly women but showed heart cavity is small,high ejection fraction.3,the results of coronary angiography in coronary artery disease:(1)part of older women coronary artery disease mainly involving the anterior descending branch of the right coronary artery(60.48%)and(45.51%),(34.13%)and the left circumflex branch(4.19%)less involved;heart failure or LM disease incidence rate was high(A2B3 VS A1B3=2.9% VS 0,P>0.05);LAD lesions appeared in the case without heart failure(A2B3 VS A2B1=42.9%VS68.8%,P < 0.05;A2B1 VS A1B1= 68.8% VS 29.4%,P < 0.05);LCX disease rate and BNP level(A2B2> A2B1> A2B3,P>0.05);not in young women without heart failure RCA lesions(A1B3 VS A1B1=12.5% VS ratio 64.7%,P < 0.05).But older women without this phenomenon.(2)the number of diseased vessels involved: elderly women single lesion and three vessel lesions(A2 VS A1=32.93% VS30.43% high,A2 VS A1=21.56%VS17.39%),double vessel disease rate is low(A2VS A1=20.36%VS26.09%);single vessel disease incidence rate and the level of BNP(A1B1>A1B2>A1B3,A2B1>A2B2>A2B3,not p>0.05);double vessel disease incidence in patients with heart failure(A2B1 VS A2B3=29.7% VS 8.6%,P<0.05);three lesions in patients with a high level of BNP(A2B3 VS A1B3= 20% VS 0,P>0.05).4,the incidence of cardiovascular events during hospitalization: elderly women prone to ventricular(9.58%)and atrial arrhythmia(8.98%),but the incidence rates were not correlated with BNP;the higher the BNP level,the more prone to three degrees of room block(12.5%)and cardiogenic shock and death(8.57%).Conclusion: 1.The BNP level after acute myocardial infarction can reflect the size of the heart and the function of the heart.The higher the significance of BNP,the more significant.After acute myocardial infarction in the elderly,the enlargement of the heart cavity is early,but the heart cavity of the elderly women with severe heart failure is smaller.2.Acute coronary artery disease in elderly women mainly involved the anterior descending coronary artery and the right coronary artery,involving the circumflexbranch and the left main coronary artery;the BNP was high in patients with coronary artery multivessel disease,and the low-level BNP group appeared in the LAD disease.3,elderly women with acute myocardial infarction are prone to atrial and ventricular arrhythmias.Heart failure patients are prone to occur in three degree way to block and cardiogenic shock and death. |
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