| Background and objectiveThe aim of this study was to investigate the temporal trends in the clinical characteristics,therapeutic pathways and outcomes of hospitalized with AMI in our hospital,so we analyze the changes in clinical baseline characteristics of patients admitted with acute myocardial infarction(AMI)in cardiac care unit(CCU)between 2007 and 2016.Materials and methodsA total of AMI patients in CCU of our hospital from January 1,2007 to December 31,2016 were collected and statistically analyzed retrospectively,including medical histories data,laboratory indicators,etc.Results(1)This study included 2591 patients with AMI from 2007 to 2016,including 1709 ST-elevation myocardial infarction(STEMI)patients,the percentage of STEMI increased significantly after 2010.(2)By analyzing the baseline characteristics data of AMI patients in the past decade,we found that the proportion of male patients was higher than female,and the proportion of male increased over time(P<0.05);the average age decreased over time(67.95±12.89 vs.63.27±12.96 vs.63.27±12.96,P<0.001);the in-hospital use of ?receptor blocker,ACEI/ARB,antiplatelet and statins increased significantly(P<0.05).The use of defibrillation and pacemaker implantation decreased over time,whereas the use of mechanical ventilation,continuous renal replacement therapy and intra-aortic balloon counterpulsation increased markedly,especially during 2007-2013(P<0.05).(3)In the past ten years,the major adverse cardiovascular events(MACE)of hospitalized with AMI was gradually decreasing,logistic regression analyses were performed to MACE between 2007 to 2016,the results showed that the mortality,cardiogenic shock,revascularization and heart failure in hospital decreased over time(P<0.05).(4)According to the different age subgroups of all patients,the percentage of middle-aged patients was highest,account for 48%.With the increase of age,the comorbidity rate of the elderly patients also was highest,however,the proportion of primary coronary intervention was lowest.The rate of major adverse cardiovascular events in the non-intervention treatment group was significantly higher than that in the intervention treatment group,especially in the elder patients(P<0.05).(5)A total of 1746 AMI patients who were treated with primary coronary intervention(PCI)over the past ten years,the proportion of multivessel lesions and coronary artery occlusion of non-elder patients was lower than the elder patients,and the rate of major adverse cardiovascular events in-hospital increased with age(12.8%vs.20.4%vs.24.7%vs.30.7%,P<0.001).Conclusions(1)In the past decade,the age of AMI patients tends to be younger,the proportion of male patients admitted with AMI were increasing.Over the past decade,the proportion of AMI patients treated with PCI increased over time.The proportion of conventional drugs including antiplatelet,statins,? blockers and ACEI/ARB increased markedly over time.However,the incidence of MACE in-hospital of AMI patients has declined over time.(2)During 2007-2016,the comorbidity rate in the elderly patients is highest,the proportion of PCI is lowest,tends to combine with multi-vessel lesion and coronary artery occlusion,and the degree of vascular disease of elder patients was serious.After treated with intervention,the incidence of MACE in elder is markedly lower than those without interventional treatment patients,however,the rate of MACE was still increasing with age.To prevent the incidence of MACE in-hospital and improve outcomes of AMI,we need pay more attention to the elderly patients. |
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